Contract Pharmacy Details

WALGREEN CO.
RWIID361301 ALABAMA DEPARTMENT OF PUBLIC HEALTH

Covered Entity Details

Entity Name

ALABAMA DEPARTMENT OF PUBLIC HEALTH

Subdivision Name

HIV AIDS DIVISION

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID361301

Entity Address

201 Monroe Street
Suite 1200
MONTGOMERY, AL 36104

Grant Number

X07HA00049

Participating Start Date

1/1/2004

Last Recertification Date

3/2/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06033
1815 9TH AVE NORTH
BESSEMER, AL 35020

Pharmacy Comments

Contract Details

Approval Date

4/16/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Allison Hatchett, Alabama RWHAP Part B Director
(334) 206-2615

Contract Pharmacy Representative

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

Signed By Date

4/16/2018

340B Drug Pricing Program Database