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WALGREEN CO.
CH09107AA SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM
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Covered Entity Details
Entity Name
SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM
Subdivision Name
Lyon-Martin Health Services, a program of HealthRIGHT360
Type
HRSA-Funded Health Center
340B ID
CH09107AA
Entity Address
1735 Mission Street
San Francisco, CA 94103
Grant Number
H80CS00049
Participating Start Date
4/1/2004
Last Recertification Date
2/24/2022
Entity Termination Date
7/1/2022
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15296
2262 MARKET ST
SAN FRANCISCO, CA 94114
Pharmacy Comments
Contract Details
Approval Date
1/6/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Vitka Eisen, CEO
(415) 762-1558
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/6/2016
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