Contract Pharmacy Details

WALGREEN CO.
CHC28978-00 ASIAN AND PACIFIC ISLANDER WELLNESS CENTER, INC.

Covered Entity Details

Entity Name

ASIAN AND PACIFIC ISLANDER WELLNESS CENTER, INC.

Subdivision Name

Asian and Pacific Islander Wellness Center

Type

HRSA-Funded Health Center

340B ID

CHC28978-00

Entity Address

726 POLK ST, 4th Floor
San Francisco, CA 94109-7812

Grant Number

H80CS28978

Participating Start Date

4/1/2016

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06291
116 NEW MONTGOMERY ST
SAN FRANCISCO, CA 94105

Pharmacy Comments

Contract Details

Approval Date

1/10/2019

Contract Begin Date

4/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Lance Toma, Chief Executive Officer
(415) 292-3400 Ext: 355

Contract Pharmacy Representative

Walgreens Co
Alisson Gannaway, Senior Analyst
(847) 964-6579

Signed By Date

1/10/2019

340B Drug Pricing Program Database