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WALGREEN CO.
CH09107P SF COMMUNITY CLINIC CONSORTIUM
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Covered Entity Details
Entity Name
SF COMMUNITY CLINIC CONSORTIUM
Subdivision Name
URGENT CARE HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH09107P
Entity Address
995 Potrero Avenue
Building 80
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 #13668
1496 MARKET STREET
SAN FRANCISCO, CA 94102
Pharmacy Comments
Contract Details
Approval Date
5/24/2009
Contract Begin Date
5/24/2009
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2017
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
3/17/2009
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