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WALGREENS MAIL SERVICE, INC.
CH09107B SF COMMUNITY CLINIC CONSORTIUM
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Covered Entity Details
Entity Name
SF COMMUNITY CLINIC CONSORTIUM
Subdivision Name
ADULT MEDICINE CLINIC
Type
HRSA-Funded Health Center
340B ID
CH09107B
Entity Address
1001 POTRERO AVENUE, ROOM 1M
SAN FRANCISCO, CA 94110
Grant Number
H80CS00049
Participating Start Date
9/30/2005
Last Recertification Date
2/13/2017
Entity Termination Date
7/1/2017
Pharmacy Details
Pharmacy Name
WALGREENS MAIL SERVICE, INC.
Pharmacy Address
8350 S RIVER PARKWAY
TEMPE, AZ 85284
Pharmacy Comments
Contract Details
Approval Date
4/18/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/9/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Susan Currin, Chief Executive Officer
(415) 206-3517
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/18/2013
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