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 SPECIALTY PHARMACY #04318
4129 18TH STREET
SAN FRANCISCO, CA 94114

Pharmacy Comments

Contract Details

Approval Date

4/8/2019

Contract Begin Date

7/1/2019

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
Shawnacie Hollinger, Walgreens Representative
(847) 964-7088

Signed By Date

4/8/2019

340B Drug Pricing Program Database