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WALGREEN CO.
STD92881 Planned Parenthood of the Pacific Southwest
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Covered Entity Details
Entity Name
Planned Parenthood of the Pacific Southwest
Subdivision Name
Corona
Type
Sexually Transmitted Diseases
340B ID
STD92881
Entity Address
2079 Compton Avenue
Suite 104
Corona, CA 92881
Grant Number
1H25PS005127
Participating Start Date
7/1/2019
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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