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WALGREEN CO.
CH098150 SOUTH COUNTY COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
SOUTH COUNTY COMMUNITY HEALTH CENTER, INC.
Subdivision Name
RAVENSWOOD FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH098150
Entity Address
1885 Bay Road
East Palo Alto, CA 94303-1312
Grant Number
H80CS00145
Participating Start Date
7/1/2002
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 00689
121 E EL CAMINO REAL
MOUNTAIN VIEW, CA 94040
Pharmacy Comments
Contract Details
Approval Date
7/1/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
LUISA BUADA, CEO
(650) 330-7410
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/1/2020
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