Contract Pharmacy Details

WALGREEN CO.
RWI97209A Cascade AIDS Project

Covered Entity Details

Entity Name

Cascade AIDS Project

Subdivision Name

Type

Ryan White Part A

340B ID

RWI97209A

Entity Address

2236 SE Belmont Street
Portland, OR 97214

Grant Number

H89HA00040

Participating Start Date

4/1/2017

Last Recertification Date

1/29/2020

Entity Termination Date

7/1/2020

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 03890
940 SE CESAR E CHAVEZ BLVD
PORTLAND, OR 97214

Pharmacy Comments

Contract Details

Approval Date

1/19/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Tyler A. TerMeer, Executive Director
(503) 278-3810

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/19/2018

340B Drug Pricing Program Database