Contract Pharmacy Details

WALGREENS SPECIALTY PHARMACY, LLC
CH09365Z CLINICAS DEL CAMINO REAL, INC.

Covered Entity Details

Entity Name

CLINICAS DEL CAMINO REAL, INC.

Subdivision Name

Clinicas del Camino Real, Incorporated - Moorpark

Type

HRSA-Funded Health Center

340B ID

CH09365Z

Entity Address

4279 Tierra Rejada Rd
Moorpark, CA 93021-3775

Grant Number

H80CS00550

Participating Start Date

10/1/2012

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

WALGREENS SPECIALTY PHARMACY, LLC

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188

Pharmacy Comments

Contract Details

Approval Date

7/13/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Robert Streeter, Chief Medical Officer
(805) 659-1740

Contract Pharmacy Representative

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

Signed By Date

7/13/2023

340B Drug Pricing Program Database