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WALGREEN CO.
CHC28369-01 ST ANTHONY MEDICAL CENTERS
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Covered Entity Details
Entity Name
ST ANTHONY MEDICAL CENTERS
Subdivision Name
St. Anthony Medical Centers - Pico Site
Type
HRSA-Funded Health Center
340B ID
CHC28369-01
Entity Address
2515 W PICO BLVD
LOS ANGELES, CA 90006-4003
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 # 07016
3724 CRENSHAW BLVD
LOS ANGELES, CA 90016
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
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
4/15/2022
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