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WALGREEN CO.
CH0911100 SAN DIEGO FAMILY CARE
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Covered Entity Details
Entity Name
SAN DIEGO FAMILY CARE
Subdivision Name
LINDA VISTA HEALTH CARE CENTER
Type
HRSA-Funded Health Center
340B ID
CH0911100
Entity Address
6973 Linda Vista Rd
San Diego, CA 92111-6342
Grant Number
H80CS02319
Participating Start Date
4/1/1996
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16490
4130 LA JOLLA VILLAGE DR STE 103
LA JOLLA, CA 92037
Pharmacy Comments
Contract Details
Approval Date
7/13/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ROBERTA L. FEINBERG, CHIEF EXECUTIVE OFFICER
(858) 279-9676
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/13/2020
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