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WALGREEN CO.
CH09107BR San Francisco Community Clinic Consortium
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Covered Entity Details
Entity Name
San Francisco Community Clinic Consortium
Subdivision Name
Tom Waddell Urban Health Clinic
Type
HRSA-Funded Health Center
340B ID
CH09107BR
Entity Address
220 Golden Gate Avenue
San Francisco, CA 94102-3706
Grant Number
H80CS00049
Participating Start Date
4/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04558
300 GOUGH STREET
SAN FRANCISCO, CA 94102
Pharmacy Comments
Contract Details
Approval Date
7/21/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Susan Ehrlich, CEO
(628) 206-8118
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/21/2018
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