Contract Pharmacy Details

WALGREEN CO.
CH097880 PETALUMA HEALTH CENTER, INC

Covered Entity Details

Entity Name

PETALUMA HEALTH CENTER, INC

Subdivision Name

Petaluma Health Center

Type

HRSA-Funded Health Center

340B ID

CH097880

Entity Address

1179 N. McDowell Blvd.
Petaluma, CA 94954-6559

Grant Number

H80CS00587

Participating Start Date

7/1/2000

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 03084
7800 OLD REDWOOD HWY
COTATI, CA 94931

Pharmacy Comments

Contract Details

Approval Date

1/15/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Brian Burns, CFO
(707) 559-7588

Contract Pharmacy Representative

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

Signed By Date

1/15/2020

340B Drug Pricing Program Database