Contract Pharmacy Details

WALGREEN CO.
HV90008 T.H.E. CLINIC INC.

Covered Entity Details

Entity Name

T.H.E. CLINIC INC.

Subdivision Name

Type

Ryan White Part C

340B ID

HV90008

Entity Address

3834 S. Western Avenue
Los Angeles, CA 90062

Grant Number

H76HA00734

Participating Start Date

7/1/2003

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06413
230 N LABREA AVE
INGLEWOOD, CA 90301

Pharmacy Comments

Contract Details

Approval Date

10/6/2015

Contract Begin Date

1/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Clifford Shiepe, President and CEO
(323) 730-1920 Ext: 3053

Contract Pharmacy Representative

Jalpa Dean, Pharmacy Manager
(310) 671-2471

Signed By Date

10/6/2015

340B Drug Pricing Program Database