340B Drug Pricing Program Database
WALGREEN CO.
FQHCLA263A MAYVIEW COMMUNITY HEALTH CENTER, INC. - information as of 5/5/2025 12:31:29 AM
Covered Entity Details
Entity Name
MAYVIEW COMMUNITY HEALTH CENTER, INC.
Subdivision Name
MAYVIEW COMMUNITY HEALTH CENTER - MV
Type
Health Center Program Look-Alike
340B ID
FQHCLA263A
Entity Address
900 MIRAMONTE AVENUE
2ND FLOOR
MOUNTAIN VIEW, CA 94040-2457
Grant Number
LALCS00001
Participating Start Date
7/1/2010
Last Recertification Date
1/27/2020
Entity Termination Date
7/1/2020
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 00689
121 E EL CAMINO REAL
MOUNTAIN VIEW, CA 94040
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kenneth Graham, CEO
(650) 475-1508
Contract Pharmacy Representative
Mayview Community Health
Ashley Peil, Director of Finance
(650) 475-1508
Signed By Date
7/12/2019
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