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WALGREEN CO.
CHC33648-02 YEHOWA MEDICAL SERVICES
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Covered Entity Details
Entity Name
YEHOWA MEDICAL SERVICES
Subdivision Name
Yehowa Medical Services -Vermont
Type
HRSA-Funded Health Center
340B ID
CHC33648-02
Entity Address
11502 S. Vermont Avenue
C
Los Angeles, CA 90044
Grant Number
H80CS33648
Participating Start Date
1/1/2020
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06249
4351 E IMPERIAL HWY
LYNWOOD, CA 90262
Pharmacy Comments
Contract Details
Approval Date
1/7/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas Tweh, Chief Executive Officer
(323) 776-1500 Ext: 1000
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/7/2020
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