Contract Pharmacy Details

WALGREEN CO.
CH090780 Community Medical Centers, Inc.

Covered Entity Details

Entity Name

Community Medical Centers, Inc.

Subdivision Name

Community Medical Centers, Channel

Type

HRSA-Funded Health Center

340B ID

CH090780

Entity Address

701 E Channel St.
Stockton, CA 95202-2628

Grant Number

H80CS00138

Participating Start Date

12/1/1992

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04107
10 WEST MAIN ST.
WOODLAND, CA 95695

Pharmacy Comments

Contract Details

Approval Date

7/2/2012

Contract Begin Date

7/2/2012

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

DAVID JOMAOAS, COO
(209) 373-2832

Contract Pharmacy Representative

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

Signed By Date

6/20/2012

340B Drug Pricing Program Database