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WALGREEN CO.
STD92243 Planned Parenthood of the Pacific Southwest
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Covered Entity Details
Entity Name
Planned Parenthood of the Pacific Southwest
Subdivision Name
Imperial Valley
Type
Sexually Transmitted Diseases
340B ID
STD92243
Entity Address
1463 South 4th Street
El Centro, CA 92243
Grant Number
1H25PS005127
Participating Start Date
1/1/2016
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #12421
13390 POWAY RD
POWAY, CA 92064
Pharmacy Comments
Contract Details
Approval Date
1/12/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
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
1/12/2022
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