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WALGREEN CO.
CH0919630 LIVINGSTON COMMUNITY HEALTH
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Covered Entity Details
Entity Name
LIVINGSTON COMMUNITY HEALTH
Subdivision Name
LIVINGSTON HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0919630
Entity Address
1140 MAIN STREET
LIVINGSTON, CA 95334
Grant Number
H80CS02588
Participating Start Date
1/1/2005
Last Recertification Date
2/5/2020
Entity Termination Date
4/1/2021
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06718
2730 SHAFFER ROAD
ATWATER, CA 95301
Pharmacy Comments
Contract Details
Approval Date
7/30/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Leslie McGowan, CEO
(209) 394-7913 Ext: 1365
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/30/2014
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