Contract Pharmacy Details

WALGREEN CO.
HV90814 CHW-CARE PROGRAM AND CLINICS

Covered Entity Details

Entity Name

CHW-CARE PROGRAM AND CLINICS

Subdivision Name

ST. MARY MEDICAL CENTER

Type

Ryan White Part C

340B ID

HV90814

Entity Address

1043 ELM AVENUE
SUITE 300
LONG BEACH, CA 90813

Grant Number

H76HA00510

Participating Start Date

4/1/2001

Last Recertification Date

2/10/2017

Entity Termination Date

4/1/2018

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05650
2627 PACIFIC AVENUE
LONG BEACH, CA 90806-2610

Pharmacy Comments

Contract Details

Approval Date

4/25/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2017
Ownership change

Contacts

Covered Entity Signing Official

Gail Daly, COO
(562) 491-9830

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/25/2014

340B Drug Pricing Program Database