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WALGREEN CO.
CH09107G SF COMMUNITY CLINIC CONSORTIUM
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Covered Entity Details
Entity Name
SF COMMUNITY CLINIC CONSORTIUM
Subdivision Name
OCEAN PARK HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH09107G
Entity Address
1351 24TH AVE
SAN FRANCISCO, CA 94122
Grant Number
H80CS00049
Participating Start Date
1/1/2003
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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