Contract Pharmacy Details

WALGREEN CO.
CH09107L SF COMMUNITY CLINIC CONSORTIUM

Covered Entity Details

Entity Name

SF COMMUNITY CLINIC CONSORTIUM

Subdivision Name

ADULT MEDICINE CLINICS-WARD 86

Type

HRSA-Funded Health Center

340B ID

CH09107L

Entity Address

995 POTRERO AVE, BLDG 80, 6TH FL
WARD 86
SAN FRANCISCO, CA 94110

Grant Number

H80CS00049

Participating Start Date

4/1/2003

Last Recertification Date

2/13/2017

Entity Termination Date

7/1/2017

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 03711
1189 POTRERO AVE
SAN FRANCISCO, CA 94110

Pharmacy Comments

Contract Details

Approval Date

11/28/2012

Contract Begin Date

11/28/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2017

Contacts

Covered Entity Signing Official

Susan Currin, Chief Executive Officer
(415) 206-3517

Contract Pharmacy Representative

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

Signed By Date

11/28/2012

340B Drug Pricing Program Database