Covered Entity Details

CH09107K SF COMMUNITY CLINIC CONSORTIUM (Terminated) - information as of 6/4/2025 12:04:49 PM

Main Details

Name

SF COMMUNITY CLINIC CONSORTIUM

Subdivision Name

FAMILY HEALTH CENTER - WARDS 81, 85

Type

HRSA-Funded Health Center

Site ID

BPS-H80-001366

340B ID

CH09107K

Grant Number

H80CS00049

Additional Details

Current Program Status

Terminated

Registration Date

4/1/2003

Participating Start Date

4/1/2003

Participating Approval Date

3/23/2004

Last Recertification Date

2/13/2017

Termination Date
Termination Reason

7/1/2017
DSH percentage below statutory minimum

Contacts

Authorizing Official

ZSFG
Susan Ehrlich, CEO
(628) 206-8118

Primary Contact

ZSFG
David Woods, Chief Pharmacy Officer
(628) 206-2332

Addresses

Street Address

995 POTRERO AVE, BLDG 80
SAN FRANCISCO, CA 94110

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
CORRECTED ENTITY NAME	03/23/2004

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
CA	PHB173920
		1447288634

Shipping Addresses

Shipping Address 1

San Francisco General Hospital
1001 Potrero Avenue, GR-1
San Francisco, CA 94110

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	03/01/2013	04/01/2013	07/01/2017	02/13/2017
Contract Detail	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012	11/28/2012	07/01/2017	02/13/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	10/15/2010	11/03/2010	07/01/2017	02/13/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009	05/24/2009	07/01/2017	02/13/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012	11/28/2012	07/01/2017	02/13/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012	11/28/2012	07/01/2017	02/13/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012	11/28/2012	07/01/2017	02/13/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012	11/28/2012	07/01/2017	02/13/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	11/28/2012	12/06/2016	01/17/2017

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
CH09107A	Terminated	BPS-H80-002543	SF COMMUNITY CLINIC CONSORTIUM	TOM WADDELL HEALTH CENTER	50 Dr Tom Waddell Pl		SAN FRANCISCO	CA
CH09107AA	Terminated	BPS-H80-009425	SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM	Lyon-Martin Health Services, a program of HealthRIGHT360	1735 Mission Street		San Francisco	CA
CH09107B	Terminated	BPS-H80-004724	SF COMMUNITY CLINIC CONSORTIUM	ADULT MEDICINE CLINIC	1001 POTRERO AVENUE, ROOM 1M		SAN FRANCISCO	CA
CH09107BM	Terminated	BPS-H80-006611	SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM	Tenderloin Health Services, a program of HealthRIGHT360	330 ELLIS ST		SAN FRANCISCO	CA
CH09107BN	Active	BPS-H80-005702	San Francisco Community Clinic Consortium	CHPY-Cole Street Clinic	Cole Street Clinic	555 Cole Street	San Francisco	CA
CH09107BP	Active	BPS-H80-006424	San Francisco Community Clinic Consortium	Balboa Teen Health Center	Balboa Teen Health Center	1000 Cayuga Avenue Room 156	San Francisco	CA
CH09107BQ	Active	BPS-H80-018201	San Francisco Community Clinic Consortium	CHPY-Larkin Street Youth Center	Larkin Street Clinic	134 Golden Gate Avenue	San Francisco	CA
CH09107BR	Active	BPS-H80-012237	San Francisco Community Clinic Consortium	Tom Waddell Urban Health Clinic	220 Golden Gate Avenue		San Francisco	CA
CH09107BS	Active	BPS-H80-032389	SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM	HealthRIGHT360 - Integrated Care Center	1563 Mission Street		San Francisco	CA
CH09107BT	Terminated	BPS-H80-018562	San Francisco Community Clinic Consortium	Saint Anthony Medical Clinic	150 Golden Gate Ave Fl 2		San Francisco	CA
CH09107BU	Terminated	BPS-H80-029947	San Francisco Community Clinic Consortium	MAXINE HALL TEMPORARY HEALTH CENTR	1181 Golden Gate Ave		San Francisco	CA
CH09107BV	Terminated	BPS-H80-027951	San Francisco Community Clinic Consortium	Castro Mission Health Center @ ZSFG	995 Potrero Ave # W81		San Francisco	CA
CH09107BW	Active	BPS-H80-010430	San Francisco Community Clinic Consortium	Medical Respite and Sobering Center	1171 Mission St		San Francisco	CA
CH09107BX	Active	BPS-H80-038520	SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM	Maria X Martinez Health Resource Center	555 Stevenson St		San Francisco	CA
CH09107BY	Active	BPS-H80-038481	SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM	Southeast Family Health Center	2403 Keith St		San Francisco	CA
CH09107C	Active	BPS-H80-002777	SF COMMUNITY CLINIC CONSORTIUM	CASTRO-MISSION HEALTH CENTER - HEALTH CENTER #1	3850 17TH ST		SAN FRANCISCO	CA
CH09107D	Active	BPS-H80-000465	SF COMMUNITY CLINIC CONSORTIUM	MAXINE HALL HEALTH CENTER	1301 PIERCE ST		SAN FRANCISCO	CA
CH09107E	Active	BPS-H80-001018	SF COMMUNITY CLINIC CONSORTIUM	SILVER AVENUE HEALTH CENTER	1525 SILVER AVE		SAN FRANCISCO	CA
CH09107F	Active	BPS-H80-004070	SF COMMUNITY CLINIC CONSORTIUM	CHINATOWN PUBLIC HEALTH CENTER	1490 MASON ST		SAN FRANCISCO	CA
CH09107G	Active	BPS-H80-001087	SF COMMUNITY CLINIC CONSORTIUM	OCEAN PARK HEALTH CENTER	1351 24TH AVE		SAN FRANCISCO	CA
CH09107H	Active	BPS-H80-005065	SF COMMUNITY CLINIC CONSORTIUM	POTRERO HILL HEALTH CTR	1050 Wisconsin Street		SAN FRANCISCO	CA
CH09107I	Active	BPS-H80-001116	SF COMMUNITY CLINIC CONSORTIUM	SOUTHEAST HEALTH CENTER	2401 KEITH STREET		SAN FRANCISCO	CA
CH09107K	Terminated	BPS-H80-001366	SF COMMUNITY CLINIC CONSORTIUM	FAMILY HEALTH CENTER - WARDS 81, 85	995 POTRERO AVE, BLDG 80		SAN FRANCISCO	CA
CH09107L	Terminated	BPS-H80-004724	SF COMMUNITY CLINIC CONSORTIUM	ADULT MEDICINE CLINICS-WARD 86	995 POTRERO AVE, BLDG 80, 6TH FL	WARD 86	SAN FRANCISCO	CA
CH09107M	Terminated	BPS-H80-005373	SF COMMUNITY CLINIC CONSORTIUM	CHILDRENS HEALTH CENTER	1001 POTRERO AVENUE, 6M		SAN FRANCISCO	CA
CH09107N	Active	BPS-H80-004412	SF COMMUNITY CLINIC CONSORTIUM	CURRY SENIOR CLINIC	333 TURK STREET		SAN FRANCISCO	CA
CH09107P	Terminated	BPS-H80-000999	SF COMMUNITY CLINIC CONSORTIUM	URGENT CARE HEALTH CENTER	995 Potrero Avenue	Building 80	SAN FRANCISCO	CA
CH09107U	Active	BPS-H80-004038	SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM	HealthRIGHT360	558 Clayton St		San Francisco	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH09107I	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013
CH09107H	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	07/01/2003	04/04/2016
CH09107A	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	04/04/2016
CH09107C	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	01/01/2018
CH09107G	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	01/01/2018
CH09107F	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	01/01/2018
CH09107D	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	01/01/2018
CH09107E	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	01/01/2018
CH09107L	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	07/01/2017
CH09107P	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	07/01/2017
CH09107N	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	01/01/2018
CH09107M	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	07/01/2017
CH09107K	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	07/01/2017
CH09107B	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	04/01/2013	07/01/2017
CH09107BQ	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	10/17/2012	01/01/2018
CH09107BN	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	10/17/2012	01/01/2018
CH09107BP	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	10/17/2012	01/01/2018
CH09107BR	AG PHARMACY		3636 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	07/01/2013	01/01/2018
CH09107BT	GARFIELD BEACH CVS, L.L.C.	CVS/PHARMACY #11107	701 VAN NESS AVENUE	SAN FRANCISCO	CA	94102	07/01/2021	07/01/2021
CH09107U	MISSION WELLNESS PHARMACY		2424 MISSION STREET	SAN FRANCISCO	CA	94110	01/01/2016
CH09107AA	MISSION WELLNESS PHARMACY		2424 MISSION STREET	SAN FRANCISCO	CA	94110	01/01/2016	07/01/2022
CH09107BM	MISSION WELLNESS PHARMACY		2424 MISSION STREET	SAN FRANCISCO	CA	94110	01/01/2016	04/01/2020
CH09107BS	MISSION WELLNESS PHARMACY		2424 MISSION STREET	SAN FRANCISCO	CA	94110	01/01/2016
CH09107BT	SAFEWAY INC	SAFEWAY PHARMACY #1507	2020 MARKET STREET ATTENTION PHAMACY MANAGER	SAN FRANCISCO	CA	94114	07/01/2021	07/01/2021
CH09107I	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012
CH09107H	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012
CH09107A	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012	04/01/2023
CH09107U	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	04/01/2013
CH09107C	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012
CH09107G	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012
CH09107F	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012
CH09107D	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012
CH09107E	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012
CH09107L	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012	07/01/2017
CH09107P	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012	07/01/2017
CH09107N	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012
CH09107M	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012	07/01/2017
CH09107K	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012	07/01/2017
CH09107AA	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	04/01/2013	07/01/2022
CH09107B	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	11/28/2012	07/01/2017
CH09107BQ	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	10/11/2012
CH09107BN	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	10/11/2012
CH09107BP	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	10/11/2012
CH09107BR	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	07/01/2013
CH09107BS	SF GENERAL HOSPITAL MED CEN	1001 POTRERO AVE	DEPT OF PHARMACY ROOM 1P2	SAN FRANCISCO	CA	94110-3518	07/01/2014
CH09107U	US BIOSERVICES	US BIOSERVICE CORPORATION	5025 PLANO PARKWAY STE 100	CARROLLTON	TX	75010	01/01/2016
CH09107AA	US BIOSERVICES	US BIOSERVICE CORPORATION	5025 PLANO PARKWAY STE 100	CARROLLTON	TX	75010	01/01/2016	12/01/2019
CH09107BM	US BIOSERVICES	US BIOSERVICE CORPORATION	5025 PLANO PARKWAY STE 100	CARROLLTON	TX	75010	01/01/2016	04/01/2020
CH09107BS	US BIOSERVICES	US BIOSERVICE CORPORATION	5025 PLANO PARKWAY STE 100	CARROLLTON	TX	75010	01/01/2016	06/22/2016
CH09107U	WALGREEN CO	DBA: WALGREENS #10044	45 CASTRO ST SUITE 124	SAN FRANCISCO	CA	94114	04/01/2016
CH09107AA	WALGREEN CO	DBA: WALGREENS #10044	45 CASTRO ST SUITE 124	SAN FRANCISCO	CA	94114	04/01/2016	07/01/2022
CH09107BM	WALGREEN CO	DBA: WALGREENS #10044	45 CASTRO ST SUITE 124	SAN FRANCISCO	CA	94114	04/01/2016	04/01/2020
CH09107BS	WALGREEN CO	DBA: WALGREENS #10044	45 CASTRO ST SUITE 124	SAN FRANCISCO	CA	94114	04/01/2016
CH09107A	WALGREEN CO	DBA: WALGREENS #11385	1580 VALENCIA ST STE 101	SAN FRANCISCO	CA	94110	07/01/2021	04/21/2022
CH09107A	WALGREEN CO	DBA: WALGREENS #10044	45 CASTRO ST SUITE 124	SAN FRANCISCO	CA	94114	07/01/2021	04/01/2023
CH09107C	WALGREEN CO	DBA: WALGREENS #10044	45 CASTRO ST SUITE 124	SAN FRANCISCO	CA	94114	10/11/2022	10/30/2024
CH09107D	WALGREEN CO	DBA: WALGREENS #10044	45 CASTRO ST SUITE 124	SAN FRANCISCO	CA	94114	10/11/2022	10/30/2024
CH09107I	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009	12/06/2016
CH09107I	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012
CH09107I	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012
CH09107I	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012
CH09107I	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012
CH09107I	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012
CH09107I	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012
CH09107H	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012
CH09107H	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012
CH09107H	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012
CH09107H	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012
CH09107H	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012
CH09107H	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107H	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012
CH09107A	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009	09/01/2020
CH09107A	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012	03/17/2021
CH09107A	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012	11/18/2021
CH09107A	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107A	WALGREEN CO.	DBA: WALGREENS #00890	135 POWELL STREET	SAN FRANCISCO	CA	94102	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 00893	1344 STOCKTON ST	SAN FRANCISCO	CA	94133	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 01054	3398 MISSION ST	SAN FRANCISCO	CA	94110	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 01120	4645 MISSION ST	SAN FRANCISCO	CA	94112	10/01/2016	11/12/2021
CH09107A	WALGREEN CO.	DBA: WALGREENS # 01126	1979 MISSION STREET	SAN FRANCISCO	CA	94103	10/01/2016	12/27/2019
CH09107A	WALGREEN CO.	DBA: WALGREENS # 01241	1201 TARAVAL ST	SAN FRANCISCO	CA	94116	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 01283	500 GEARY ST	SAN FRANCISCO	CA	94102	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 01327	498 CASTRO ST	SAN FRANCISCO	CA	94114	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 01626	2494 SAN BRUNO AVE	SAN FRANCISCO	CA	94134	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 02153	790 VAN NESS AVE	SAN FRANCISCO	CA	94102	10/01/2016	11/11/2020
CH09107A	WALGREEN CO.	DBA: WALGREENS # 02244	3801 3RD STREET, SUITE 550	SAN FRANCISCO	CA	94124	10/01/2016	07/22/2019
CH09107A	WALGREEN CO.	DBA: WALGREENS # 02705	2050 IRVING ST	SAN FRANCISCO	CA	94122	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 02866	1363 DIVISADERO ST	SAN FRANCISCO	CA	94115	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 03185	825 MARKET STREET	SAN FRANCISCO	CA	94103	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 03475	25 POINT LOBOS AVE	SAN FRANCISCO	CA	94121	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 03849	745 CLEMENT ST	SAN FRANCISCO	CA	94118	10/01/2016	11/16/2021
CH09107A	WALGREEN CO.	DBA: WALGREENS # 03869	1750 NORIEGA ST	SAN FRANCISCO	CA	94122	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 04231	2690 MISSION ST	SAN FRANCISCO	CA	94110	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #04318	4129 18TH STREET	SAN FRANCISCO	CA	94114	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 04609	1301 MARKET STREET	SAN FRANCISCO	CA	94103	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 05487	5300 3RD STREET	SAN FRANCISCO	CA	94124	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 06557	199 PARNASSUS	SAN FRANCISCO	CA	94117-4260	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS # 07150	965 GENEVA AVE	SAN FRANCISCO	CA	94112	10/01/2016	04/01/2023
CH09107A	WALGREEN CO.	DBA: WALGREENS #13583	901 HYDE STREET	SAN FRANCISCO	CA	94109	10/01/2016	08/29/2019
CH09107A	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15296	2262 MARKET ST	SAN FRANCISCO	CA	94114	10/01/2016	04/01/2023
CH09107U	WALGREEN CO.	DBA: WALGREENS # 01126	1979 MISSION STREET	SAN FRANCISCO	CA	94103	04/01/2015
CH09107U	WALGREEN CO.	DBA: WALGREENS # 01327	498 CASTRO ST	SAN FRANCISCO	CA	94114	04/01/2015
CH09107U	WALGREEN CO.	DBA: WALGREENS # 02153	790 VAN NESS AVE	SAN FRANCISCO	CA	94102	04/01/2015
CH09107U	WALGREEN CO.	DBA: WALGREENS # 03185	825 MARKET STREET	SAN FRANCISCO	CA	94103	04/01/2015
CH09107U	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	04/01/2015
CH09107U	WALGREEN CO.	DBA: WALGREENS # 04609	1301 MARKET STREET	SAN FRANCISCO	CA	94103	04/01/2015
CH09107U	WALGREEN CO.	DBA: WALGREENS # 06557	199 PARNASSUS	SAN FRANCISCO	CA	94117-4260	04/01/2015
CH09107U	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	04/01/2015
CH09107U	WALGREEN CO.	DBA: WALGREENS #13583	901 HYDE STREET	SAN FRANCISCO	CA	94109	10/01/2015
CH09107U	WALGREEN CO.	DBA: WALGREENS # 04529	2145 MARKET STREET	SAN FRANCISCO	CA	94114	01/01/2016
CH09107U	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15296	2262 MARKET ST	SAN FRANCISCO	CA	94114	04/01/2016
CH09107U	WALGREEN CO.	DBA WALGREENS #16373	550 16TH STREET ROOM 1200	SAN FRANCISCO	CA	94158	10/01/2016
CH09107U	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #04318	4129 18TH STREET	SAN FRANCISCO	CA	94114	01/01/2017
CH09107U	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16477	3009 BROADWAY	OAKLAND	CA	94611	04/01/2017
CH09107U	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	04/01/2017
CH09107U	WALGREEN CO.	DBA: WALGREENS #15331	500 PARNASSUS AVENUE LEVEL J, ROOM MU-145	SAN FRANCISCO	CA	94143	04/01/2017
CH09107U	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2017
CH09107C	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/03/2010	10/06/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009	10/06/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012	10/06/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012	02/26/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012	02/27/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012	02/25/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107G	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	05/24/2009
CH09107G	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012
CH09107G	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012
CH09107G	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012
CH09107G	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012
CH09107G	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107G	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012
CH09107F	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009	12/06/2016
CH09107F	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012
CH09107F	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012
CH09107F	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012
CH09107F	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012
CH09107F	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012
CH09107F	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012
CH09107D	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009	12/06/2016
CH09107D	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012	10/06/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012	02/26/2025
CH09107D	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012	10/06/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012	02/27/2025
CH09107D	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012	02/25/2025
CH09107D	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	10/06/2022
CH09107E	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009
CH09107E	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012
CH09107E	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012
CH09107E	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012
CH09107E	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012
CH09107E	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012
CH09107E	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107L	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009	07/01/2017
CH09107L	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012	07/01/2017
CH09107L	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012	07/01/2017
CH09107L	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012	07/01/2017
CH09107L	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012	07/01/2017
CH09107L	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012	07/01/2017
CH09107L	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107P	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/03/2010	07/01/2017
CH09107P	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009	07/01/2017
CH09107P	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012	07/01/2017
CH09107P	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012	07/01/2017
CH09107P	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012	07/01/2017
CH09107P	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012	07/01/2017
CH09107P	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107N	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	05/24/2009
CH09107N	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012
CH09107N	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012
CH09107N	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012
CH09107N	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012
CH09107N	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107N	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012
CH09107M	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/03/2010	07/01/2017
CH09107M	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009	07/01/2017
CH09107M	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012	07/01/2017
CH09107M	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012	07/01/2017
CH09107M	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012	07/01/2017
CH09107M	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012	07/01/2017
CH09107M	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107K	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/03/2010	07/01/2017
CH09107K	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009	07/01/2017
CH09107K	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012	07/01/2017
CH09107K	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012	07/01/2017
CH09107K	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012	07/01/2017
CH09107K	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012	07/01/2017
CH09107K	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107AA	WALGREEN CO.	DBA: WALGREENS # 01126	1979 MISSION STREET	SAN FRANCISCO	CA	94103	01/01/2016	07/01/2022
CH09107AA	WALGREEN CO.	DBA: WALGREENS # 01327	498 CASTRO ST	SAN FRANCISCO	CA	94114	01/01/2016	07/01/2022
CH09107AA	WALGREEN CO.	DBA: WALGREENS # 02153	790 VAN NESS AVE	SAN FRANCISCO	CA	94102	01/01/2016	07/01/2022
CH09107AA	WALGREEN CO.	DBA: WALGREENS # 03185	825 MARKET STREET	SAN FRANCISCO	CA	94103	01/01/2016	07/01/2022
CH09107AA	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	01/01/2016	07/01/2022
CH09107AA	WALGREEN CO.	DBA: WALGREENS # 04609	1301 MARKET STREET	SAN FRANCISCO	CA	94103	01/01/2016	07/01/2022
CH09107AA	WALGREEN CO.	DBA: WALGREENS # 06557	199 PARNASSUS	SAN FRANCISCO	CA	94117-4260	01/01/2016	07/01/2022
CH09107AA	WALGREEN CO.	DBA: WALGREENS #13583	901 HYDE STREET	SAN FRANCISCO	CA	94109	01/01/2016	12/01/2019
CH09107AA	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	01/01/2016	07/01/2022
CH09107AA	WALGREEN CO.	DBA: WALGREENS # 04529	2145 MARKET STREET	SAN FRANCISCO	CA	94114	01/01/2016	07/01/2022
CH09107AA	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15296	2262 MARKET ST	SAN FRANCISCO	CA	94114	04/01/2016	07/01/2022
CH09107AA	WALGREEN CO.	DBA WALGREENS #16373	550 16TH STREET ROOM 1200	SAN FRANCISCO	CA	94158	10/01/2016	07/01/2022
CH09107AA	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #04318	4129 18TH STREET	SAN FRANCISCO	CA	94114	01/01/2017	07/01/2022
CH09107AA	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	04/01/2017	07/01/2022
CH09107AA	WALGREEN CO.	DBA: WALGREENS #15331	500 PARNASSUS AVENUE LEVEL J, ROOM MU-145	SAN FRANCISCO	CA	94143	04/01/2017	07/01/2022
CH09107AA	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16477	3009 BROADWAY	OAKLAND	CA	94611	04/01/2017	07/01/2022
CH09107B	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/03/2010	07/01/2017
CH09107B	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	05/24/2009	07/01/2017
CH09107B	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012	07/01/2017
CH09107B	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012	07/01/2017
CH09107B	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012	07/01/2017
CH09107B	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012	07/01/2017
CH09107B	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107BM	WALGREEN CO.	DBA: WALGREENS #13583	901 HYDE STREET	SAN FRANCISCO	CA	94109	01/15/2011	04/01/2020
CH09107BM	WALGREEN CO.	DBA: WALGREENS # 01126	1979 MISSION STREET	SAN FRANCISCO	CA	94103	10/01/2015	04/01/2020
CH09107BM	WALGREEN CO.	DBA: WALGREENS # 01327	498 CASTRO ST	SAN FRANCISCO	CA	94114	10/01/2015	04/01/2020
CH09107BM	WALGREEN CO.	DBA: WALGREENS # 02153	790 VAN NESS AVE	SAN FRANCISCO	CA	94102	10/01/2015	04/01/2020
CH09107BM	WALGREEN CO.	DBA: WALGREENS # 03185	825 MARKET STREET	SAN FRANCISCO	CA	94103	10/01/2015	04/01/2020
CH09107BM	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	10/01/2015	04/01/2020
CH09107BM	WALGREEN CO.	DBA: WALGREENS # 04609	1301 MARKET STREET	SAN FRANCISCO	CA	94103	10/01/2015	04/01/2020
CH09107BM	WALGREEN CO.	DBA: WALGREENS # 06557	199 PARNASSUS	SAN FRANCISCO	CA	94117-4260	10/01/2015	04/01/2020
CH09107BM	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	10/01/2015	04/01/2020
CH09107BM	WALGREEN CO.	DBA: WALGREENS # 04529	2145 MARKET STREET	SAN FRANCISCO	CA	94114	01/01/2016	04/01/2020
CH09107BM	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15296	2262 MARKET ST	SAN FRANCISCO	CA	94114	04/01/2016	04/01/2020
CH09107BM	WALGREEN CO.	DBA WALGREENS #16373	550 16TH STREET ROOM 1200	SAN FRANCISCO	CA	94158	10/01/2016	04/01/2020
CH09107BM	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #04318	4129 18TH STREET	SAN FRANCISCO	CA	94114	01/01/2017	04/01/2020
CH09107BM	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	04/01/2017	04/01/2020
CH09107BM	WALGREEN CO.	DBA: WALGREENS #15331	500 PARNASSUS AVENUE LEVEL J, ROOM MU-145	SAN FRANCISCO	CA	94143	04/01/2017	04/01/2020
CH09107BM	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16477	3009 BROADWAY	OAKLAND	CA	94611	04/01/2017	04/01/2020
CH09107BQ	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	08/20/2012
CH09107BQ	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012
CH09107BQ	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107BQ	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012
CH09107BQ	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012
CH09107BQ	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012
CH09107BQ	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012
CH09107BN	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	08/22/2012
CH09107BN	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012
CH09107BN	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107BN	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012
CH09107BN	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012
CH09107BN	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012
CH09107BN	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	11/28/2012
CH09107BP	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	08/22/2012
CH09107BP	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	11/28/2012
CH09107BP	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012	12/06/2016
CH09107BP	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	11/28/2012
CH09107BP	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	11/28/2012
CH09107BP	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	11/28/2012
CH09107BP	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	11/28/2012
CH09107BR	WALGREEN CO.	DBA: WALGREENS # 01393	1630 OCEAN AVE	SAN FRANCISCO	CA	94112	07/01/2013
CH09107BR	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	07/01/2013
CH09107BR	WALGREEN CO.	DBA: WALGREENS #09886	3400 CESAR CHAVEZ	SAN FRANCISCO	CA	94110	07/01/2013
CH09107BR	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	07/01/2013
CH09107BR	WALGREEN CO.	DBA: WALGREENS #13667	5280 GEARY BLVD	SAN FRANCISCO	CA	94118	07/01/2013
CH09107BR	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	07/01/2013
CH09107BR	WALGREEN CO.	DBA: WALGREENS #13669	776 MARKET STREET	SAN FRANCISCO	CA	94102	07/01/2013	12/06/2016
CH09107BS	WALGREEN CO.	DBA: WALGREENS # 01126	1979 MISSION STREET	SAN FRANCISCO	CA	94103	04/01/2015
CH09107BS	WALGREEN CO.	DBA: WALGREENS # 01327	498 CASTRO ST	SAN FRANCISCO	CA	94114	04/01/2015
CH09107BS	WALGREEN CO.	DBA: WALGREENS # 02153	790 VAN NESS AVE	SAN FRANCISCO	CA	94102	04/01/2015
CH09107BS	WALGREEN CO.	DBA: WALGREENS # 03185	825 MARKET STREET	SAN FRANCISCO	CA	94103	04/01/2015	02/25/2025
CH09107BS	WALGREEN CO.	DBA: WALGREENS # 03711	1189 POTRERO AVE	SAN FRANCISCO	CA	94110	04/01/2015	02/26/2025
CH09107BS	WALGREEN CO.	DBA: WALGREENS # 04609	1301 MARKET STREET	SAN FRANCISCO	CA	94103	04/01/2015
CH09107BS	WALGREEN CO.	DBA: WALGREENS # 06557	199 PARNASSUS	SAN FRANCISCO	CA	94117-4260	04/01/2015
CH09107BS	WALGREEN CO.	DBA: WALGREENS #13668	1496 MARKET STREET	SAN FRANCISCO	CA	94102	04/01/2015
CH09107BS	WALGREEN CO.	DBA: WALGREENS #13583	901 HYDE STREET	SAN FRANCISCO	CA	94109	10/01/2015	12/01/2019
CH09107BS	WALGREEN CO.	DBA: WALGREENS # 04529	2145 MARKET STREET	SAN FRANCISCO	CA	94114	01/01/2016
CH09107BS	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15296	2262 MARKET ST	SAN FRANCISCO	CA	94114	04/01/2016
CH09107BS	WALGREEN CO.	DBA WALGREENS #16373	550 16TH STREET ROOM 1200	SAN FRANCISCO	CA	94158	10/01/2016
CH09107BS	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #04318	4129 18TH STREET	SAN FRANCISCO	CA	94114	01/01/2017
CH09107BS	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16477	3009 BROADWAY	OAKLAND	CA	94611	04/01/2017
CH09107BS	WALGREEN CO.	DBA: WALGREENS #13666	1300 BUSH STREET	SAN FRANCISCO	CA	94109	04/01/2017
CH09107BS	WALGREEN CO.	DBA: WALGREENS #15331	500 PARNASSUS AVENUE LEVEL J, ROOM MU-145	SAN FRANCISCO	CA	94143	04/01/2017
CH09107BS	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2017
CH09107BQ	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018
CH09107H	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018
CH09107I	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018
CH09107D	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018	10/06/2022
CH09107BP	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018
CH09107C	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018	10/06/2022
CH09107N	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018
CH09107BR	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018
CH09107BN	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018
CH09107G	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018
CH09107A	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018	11/16/2021
CH09107F	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018
CH09107E	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	10/01/2018
CH09107A	WALGREEN CO.	DBA: WALGREENS # 00887	1524 POLK STREET	SAN FRANCISCO	CA	94109	07/01/2021	04/01/2023
CH09107BT	WALGREEN CO.	DBA: WALGREENS # 04558	300 GOUGH STREET	SAN FRANCISCO	CA	94102	07/01/2021	07/01/2021
CH09107BT	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16533	1100 VAN NESS AVE STE C	SAN FRANCISCO	CA	94109	07/01/2021	07/01/2021
CH09107BT	WALGREEN CO.	DBA: WALGREENS # 02152	1899 FILLMORE ST	SAN FRANCISCO	CA	94115	07/01/2021	07/01/2021
CH09107BT	WALGREEN CO.	DBA: WALGREENS # 04609	1301 MARKET STREET	SAN FRANCISCO	CA	94103	07/01/2021	07/01/2021
CH09107A	WALGREEN CO.	DBA: WALGREENS # 04570	3001 TARAVAL STREET	SAN FRANCISCO	CA	94116	01/01/2022	04/01/2023
CH09107C	WALGREEN CO.	DBA: WALGREENS # 01054	3398 MISSION ST	SAN FRANCISCO	CA	94110	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 00887	1524 POLK STREET	SAN FRANCISCO	CA	94109	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 02866	1363 DIVISADERO ST	SAN FRANCISCO	CA	94115	10/11/2022	02/24/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS # 00893	1344 STOCKTON ST	SAN FRANCISCO	CA	94133	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 00893	1344 STOCKTON ST	SAN FRANCISCO	CA	94133	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 01327	498 CASTRO ST	SAN FRANCISCO	CA	94114	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 02705	2050 IRVING ST	SAN FRANCISCO	CA	94122	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 00887	1524 POLK STREET	SAN FRANCISCO	CA	94109	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 02705	2050 IRVING ST	SAN FRANCISCO	CA	94122	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 07150	965 GENEVA AVE	SAN FRANCISCO	CA	94112	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 02866	1363 DIVISADERO ST	SAN FRANCISCO	CA	94115	10/11/2022	02/24/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS # 04570	3001 TARAVAL STREET	SAN FRANCISCO	CA	94116	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 06557	199 PARNASSUS	SAN FRANCISCO	CA	94117-4260	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 07150	965 GENEVA AVE	SAN FRANCISCO	CA	94112	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS #00890	135 POWELL STREET	SAN FRANCISCO	CA	94102	10/11/2022	02/27/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS # 04609	1301 MARKET STREET	SAN FRANCISCO	CA	94103	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 01241	1201 TARAVAL ST	SAN FRANCISCO	CA	94116	10/11/2022	02/24/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS # 03475	25 POINT LOBOS AVE	SAN FRANCISCO	CA	94121	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS #00890	135 POWELL STREET	SAN FRANCISCO	CA	94102	10/11/2022	02/27/2025
CH09107D	WALGREEN CO.	DBA: WALGREENS # 03869	1750 NORIEGA ST	SAN FRANCISCO	CA	94122	10/11/2022	02/25/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS # 03869	1750 NORIEGA ST	SAN FRANCISCO	CA	94122	10/11/2022	02/25/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS # 03185	825 MARKET STREET	SAN FRANCISCO	CA	94103	10/11/2022	02/25/2025
CH09107D	WALGREEN CO.	DBA: WALGREENS # 05487	5300 3RD STREET	SAN FRANCISCO	CA	94124	10/11/2022	02/27/2025
CH09107D	WALGREEN CO.	DBA: WALGREENS # 01054	3398 MISSION ST	SAN FRANCISCO	CA	94110	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 01626	2494 SAN BRUNO AVE	SAN FRANCISCO	CA	94134	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 04231	2690 MISSION ST	SAN FRANCISCO	CA	94110	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 01241	1201 TARAVAL ST	SAN FRANCISCO	CA	94116	10/11/2022	02/24/2025
CH09107C	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15296	2262 MARKET ST	SAN FRANCISCO	CA	94114	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 04231	2690 MISSION ST	SAN FRANCISCO	CA	94110	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 01283	500 GEARY ST	SAN FRANCISCO	CA	94102	10/11/2022	11/16/2023
CH09107D	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #04318	4129 18TH STREET	SAN FRANCISCO	CA	94114	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 04609	1301 MARKET STREET	SAN FRANCISCO	CA	94103	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 04570	3001 TARAVAL STREET	SAN FRANCISCO	CA	94116	10/11/2022
CH09107C	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #04318	4129 18TH STREET	SAN FRANCISCO	CA	94114	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 01327	498 CASTRO ST	SAN FRANCISCO	CA	94114	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 06557	199 PARNASSUS	SAN FRANCISCO	CA	94117-4260	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 03475	25 POINT LOBOS AVE	SAN FRANCISCO	CA	94121	10/11/2022
CH09107D	WALGREEN CO.	DBA: WALGREENS # 03185	825 MARKET STREET	SAN FRANCISCO	CA	94103	10/11/2022	02/25/2025
CH09107D	WALGREEN CO.	DBA: WALGREENS # 01626	2494 SAN BRUNO AVE	SAN FRANCISCO	CA	94134	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 01283	500 GEARY ST	SAN FRANCISCO	CA	94102	10/11/2022	11/16/2023
CH09107C	WALGREEN CO.	DBA: WALGREENS # 05487	5300 3RD STREET	SAN FRANCISCO	CA	94124	10/11/2022	02/27/2025
CH09107D	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15296	2262 MARKET ST	SAN FRANCISCO	CA	94114	10/11/2022
CH09107C	WALGREEN CO.	DBA: WALGREENS # 02152	1899 FILLMORE ST	SAN FRANCISCO	CA	94115	04/01/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS # 04529	2145 MARKET STREET	SAN FRANCISCO	CA	94114	04/01/2025
CH09107D	WALGREEN CO.	DBA: WALGREENS # 07043	459 POWELL ST	SAN FRANCISCO	CA	94102	04/01/2025
CH09107D	WALGREEN CO.	DBA: WALGREENS # 02152	1899 FILLMORE ST	SAN FRANCISCO	CA	94115	04/01/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS #13670	200 WEST PORTAL AVE	SAN FRANCISCO	CA	94127	04/01/2025
CH09107C	WALGREEN CO.	DBA: WALGREENS # 07043	459 POWELL ST	SAN FRANCISCO	CA	94102	04/01/2025
CH09107D	WALGREEN CO.	DBA: WALGREENS # 04529	2145 MARKET STREET	SAN FRANCISCO	CA	94114	04/01/2025
CH09107D	WALGREEN CO.	DBA: WALGREENS #13670	200 WEST PORTAL AVE	SAN FRANCISCO	CA	94127	04/01/2025
CH09107U	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	04/01/2015	08/03/2015
CH09107U	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	04/01/2015	08/03/2015
CH09107BS	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	04/01/2015	08/03/2015
CH09107BS	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	04/01/2015	08/03/2015
CH09107U	WELLPARTNER, INC	20800 SW 115TH AVE	SUITE 100	TUALATIN	OR	97062	07/01/2016
CH09107AA	WELLPARTNER, INC	20800 SW 115TH AVE	SUITE 100	TUALATIN	OR	97062	07/01/2016	12/01/2019
CH09107BM	WELLPARTNER, INC	20800 SW 115TH AVE	SUITE 100	TUALATIN	OR	97062	07/01/2016	04/01/2020
CH09107BS	WELLPARTNER, INC	20800 SW 115TH AVE	SUITE 100	TUALATIN	OR	97062	07/01/2016	12/01/2019

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Profile Change Request	Ehrlich, Susan CEO ZSFG 4152068118	Ehrlich, Susan CEO ZSFG 6282068118	9/8/2019 10:31 AM
Contacts	Primary Contact	Update	Profile Change Request	Woods, David Chief Pharmacy Officer ZSFG 4152062332	Woods, David Chief Pharmacy Officer ZSFG 6282062332	9/3/2019 6:30 PM
Contacts	Authorizing Official	Update		Ehrlich, Susan CEO 4152068118	Ehrlich, Susan CEO ZSFG 4152068118	10/2/2017 1:13 PM
Contacts	Primary Contact	Update		Woods, David Chief Pharmacy Officer 4152062332	Woods, David Chief Pharmacy Officer ZSFG 4152062332	10/2/2017 12:01 PM
Contacts	Authorizing Official	Update		Pickens, Roland Interim CEO 4155542610	Ehrlich, Susan CEO 4152068118	6/28/2017 3:13 PM
Contacts	Primary Contact	Insert			Woods, David Chief Pharmacy Officer 4152062332	6/28/2017 3:13 PM
Addresses	Main Address	Insert			995 POTRERO AVE, BLDG 80 SAN FRANCISCO, CA 94110	6/28/2017 3:13 PM
Addresses	Shipping Address	Insert			San Francisco General Hospital 1001 Potrero Avenue, GR-1 San Francisco, CA 94110	6/28/2017 3:13 PM
Dates	Last Date That 340B Drugs Purchased	Update			6/27/2017 12:00:00 AM	6/28/2017 3:12 PM
Details	State	Update		Active	Terminated	6/28/2017 3:12 PM
Terminations	Termination Comments	Update			This termination is requested because this clinic/entity is 340b eligible under SFCCC CH09107K and DSH050228D. All purchases of 340b meds have been attributed to DSH050228D. This request is made to prevent duplication.	6/28/2017 3:12 PM
Terminations	Termination Date	Update			7/1/2017 12:00:00 AM	6/28/2017 3:12 PM
Terminations	Termination Effective Date	Update			6/27/2017 12:00:00 AM	6/28/2017 3:12 PM
Terminations	Termination Reason	Update			DSH percentage below statutory minimum	6/28/2017 3:12 PM
Details	Last Recertification Date	Update		2/26/2016 12:00:00 AM	2/13/2017 12:00:00 AM	2/13/2017 12:06 PM
Contacts	Authorizing Official	Update		GRESSMAN, JOHN CEO 4153552220	Pickens, Roland Interim CEO 4155542610	1/17/2017 11:46 AM
Details	Last Recertification Date	Update		3/5/2015 12:00:00 AM	2/26/2016 12:00:00 AM	2/26/2016 2:35 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	3/19/2015 12:41 PM
Medicaid Billing	Medicaid: Number	Insert			PHB173920	3/19/2015 12:41 PM
Medicaid Billing	Medicaid: State	Insert			CA	3/19/2015 12:41 PM
Medicaid Billing	NPI: Number	Insert			1447288634	3/5/2015 12:26 PM
Details	Last Recertification Date	Update		2/24/2014 12:00:00 AM	3/5/2015 12:00:00 AM	3/5/2015 12:26 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	2/24/2014 12:00:00 AM	2/24/2014 2:36 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	3/11/2013 2:45 PM
Dates	Participating Approval Date	Update		3/23/2004 2:35:30 PM	3/23/2004 12:00:00 AM	12/12/2012 3:46 PM
Contacts	Authorizing Official	Insert			GRESSMAN, JOHN CEO 4153552220	1/12/2010 3:50 PM
Details	Last Recertification Date	Insert				3/23/2004 2:35 PM
Details	Grant Number	Insert			H80CS00049	3/23/2004 2:35 PM
Details	340B ID	Insert			CH09107K	3/23/2004 2:35 PM
Details	Is Authorizing Official EHB Data	Insert				3/23/2004 2:35 PM
Dates	Last Date That 340B Drugs Purchased	Insert				3/23/2004 2:35 PM
Details	Medicare Provider Number	Insert				3/23/2004 2:35 PM
Details	Entity Name	Insert			SF COMMUNITY CLINIC CONSORTIUM	3/23/2004 2:35 PM
Details	Program Code	Insert			CH	3/23/2004 2:35 PM
Details	Entity Subname	Insert			FAMILY HEALTH CENTER - WARDS 81, 85	3/23/2004 2:35 PM
Dates	Participating Approval Date	Insert			3/23/2004 2:35:30 PM	3/23/2004 2:35 PM
Details	State	Insert			Active	3/23/2004 2:35 PM
Dates	Registration Date	Insert			4/1/2003 12:00:00 AM	3/23/2004 2:35 PM
Dates	Signed By Date	Insert				3/23/2004 2:35 PM
Dates	Start Date	Insert			4/1/2003 12:00:00 AM	3/23/2004 2:35 PM
Terminations	Termination Comments	Insert				3/23/2004 2:35 PM
Terminations	Termination Date	Insert				3/23/2004 2:35 PM
Terminations	Termination Effective Date	Insert				3/23/2004 2:35 PM
Terminations	Termination Reason	Insert				3/23/2004 2:35 PM
Details	Comments Public	Insert			CORRECTED ENTITY NAME	3/23/2004 2:35 PM

340B Drug Pricing Program Database