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WALGREEN CO.
STD78208 San Antonio AIDS Foundation
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Covered Entity Details
Entity Name
San Antonio AIDS Foundation
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD78208
Entity Address
818 E. Grayson St
San Antonio, TX 78208
Grant Number
NU62PS924529
Participating Start Date
4/1/2017
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #12479
121 N. ZARZAMORA ST.
SAN ANTONIO, TX 78207-3739
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/12/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Cynthia Nelson, Chief Executive Officer
(210) 225-4715 Ext: 122
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/12/2018
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