Contract Pharmacy Details

WALGREEN CO.
FQHCLA002A COUNTY OF MONTEREY

Covered Entity Details

Entity Name

COUNTY OF MONTEREY

Subdivision Name

MARINA CLINIC

Type

Health Center Program Look-Alike

340B ID

FQHCLA002A

Entity Address

3155 DEFOREST ROAD
MARINA, CA 93933

Grant Number

LALCS00049

Participating Start Date

10/1/2001

Last Recertification Date

1/31/2019

Entity Termination Date

4/1/2020

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04997
226 RESERVATION RD.
MARINA, CA 93933

Pharmacy Comments

Contract Details

Approval Date

4/3/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Julia C. Edgcomb, Clinic Services Bureau Chief/Director
(831) 796-1386

Contract Pharmacy Representative

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

Signed By Date

4/3/2014

340B Drug Pricing Program Database