Contract Pharmacy Details

WALGREEN CO
CH091670 VISTA COMMUNITY CLINIC

Covered Entity Details

Entity Name

VISTA COMMUNITY CLINIC

Subdivision Name

VCC: VALE TERRACE

Type

HRSA-Funded Health Center

340B ID

CH091670

Entity Address

1000 Vale Terrace Dr.
Vista, CA 92084-5218

Grant Number

H80CS00282

Participating Start Date

4/1/1996

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO

Pharmacy Address

DBA: WALGREENS #09433
3752 MISSION AVE
OCEANSIDE, CA 92058

Pharmacy Comments

Contract Details

Approval Date

12/29/2011

Contract Begin Date

12/29/2011

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Barbara Mannino, CEO
(760) 631-5000

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

12/15/2011

340B Drug Pricing Program Database