Contract Pharmacy Details

WALGREEN CO.
RWI95811 Sunburst Projects

Covered Entity Details

Entity Name

Sunburst Projects

Subdivision Name

Type

Ryan White Part A

340B ID

RWI95811

Entity Address

2143 Hurley Way , Suite 240
Sacramento, CA 95825

Grant Number

H89HA00048

Participating Start Date

4/1/2014

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #21193
1757 W SAN CARLOS ST
SAN JOSE, CA 95128

Pharmacy Comments

Contract Details

Approval Date

7/14/2020

Contract Begin Date

7/29/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jacob Bradley-Rowe, Executive Director
(916) 709-7692

Contract Pharmacy Representative

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

Signed By Date

7/14/2020

340B Drug Pricing Program Database