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WALGREEN CO.
CH09107A SF COMMUNITY CLINIC CONSORTIUM
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Covered Entity Details
Entity Name
SF COMMUNITY CLINIC CONSORTIUM
Subdivision Name
TOM WADDELL HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH09107A
Entity Address
50 Dr Tom Waddell Pl
SAN FRANCISCO, CA 94102
Grant Number
H80CS00049
Participating Start Date
7/1/1997
Last Recertification Date
1/31/2023
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 00887
1524 POLK STREET
SAN FRANCISCO, CA 94109
Pharmacy Comments
Contract Details
Approval Date
4/14/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Susan Ehrlich, CEO
(628) 206-8118
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/14/2021
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