Contract Pharmacy Details

WALGREEN CO.
CH099010 BORREGO COMMUNITY HEALTH FOUNDATION

Covered Entity Details

Entity Name

BORREGO COMMUNITY HEALTH FOUNDATION

Subdivision Name

BORREGO COMMUNITY HEALTH FOUNDATION

Type

HRSA-Funded Health Center

340B ID

CH099010

Entity Address

4343 YAQUI PASS ROAD
BORREGO SPRINGS, CA 92004-2369

Grant Number

H80CS00287

Participating Start Date

1/1/2003

Last Recertification Date

2/13/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 02223
17383 MAIN STREET
HESPERIA, CA 92345-6117

Pharmacy Comments

Contract Details

Approval Date

8/3/2012

Contract Begin Date

8/3/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

BRUCE HEBETS, CEO
(760) 767-6433

Contract Pharmacy Representative

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

Signed By Date

7/9/2012

340B Drug Pricing Program Database