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WALGREEN CO.
STD920251 Planned Parenthood of the Pacific Southwest
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Covered Entity Details
Entity Name
Planned Parenthood of the Pacific Southwest
Subdivision Name
Escondido
Type
Sexually Transmitted Diseases
340B ID
STD920251
Entity Address
347 W. Mission Avenue
Escondido, CA 92025
Grant Number
1H25PS005127
Participating Start Date
1/1/2016
Last Recertification Date
5/21/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09389
310 SYCAMORE AVENUE
VISTA, CA 92083-7702
Pharmacy Comments
Contract Details
Approval Date
4/13/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/8/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Darrah Johnson, CEO
(619) 881-5050 Ext: 6198815050
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/13/2021
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