340B Drug Pricing Program Database
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WALGREEN CO.
RWI946091 Primary Care at Home, INC.
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Covered Entity Details
Entity Name
Primary Care at Home, INC.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI946091
Entity Address
400 - 29th Street
Suite 306
Oakland, CA 94609
Grant Number
H89HA00018
Participating Start Date
5/10/2021
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 02306
1138 W TENNYSON RD
HAYWARD, CA 94544
Pharmacy Comments
Contract Details
Approval Date
1/13/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anthony E. Jones, Board Chair
(510) 822-2588
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/13/2022
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