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WALGREEN CO.
CH092440 CLINIC INC, THE
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Covered Entity Details
Entity Name
CLINIC INC, THE
Subdivision Name
T.H.E. CLINIC, INC.
Type
HRSA-Funded Health Center
340B ID
CH092440
Entity Address
3834 S. WESTERN AVE
LOS ANGELES, CA 90062-1104
Grant Number
H80CS00755
Participating Start Date
7/1/2003
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15294
8490 SANTA MONICA BLVD STE 1
WEST HOLLYWOOD, CA 90069
Pharmacy Comments
Contract Details
Approval Date
10/14/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Clifford Shiepe, President and CEO
(323) 730-1920 Ext: 3053
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/14/2020
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