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WALGREEN CO
CHC28369-00 ST ANTHONY MEDICAL CENTERS
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Covered Entity Details
Entity Name
ST ANTHONY MEDICAL CENTERS
Subdivision Name
St. Anthony Medical Centers - Hollywood Site
Type
HRSA-Funded Health Center
340B ID
CHC28369-00
Entity Address
6368 HOLLYWOOD BLVD
LOS ANGELES, CA 90028-6320
Grant Number
H80CS28369
Participating Start Date
7/1/2016
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS # 09136
1625 W SUNSET BLVD
LOS ANGELES, CA 90026
Pharmacy Comments
Contract Details
Approval Date
4/7/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
rita george, coo
(661) 388-1543
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/7/2022
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