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WALGREENS SPECIALTY PHARMACY, LLC
CH09365E CLINICAS DEL CAMINO REAL, INC.
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Covered Entity Details
Entity Name
CLINICAS DEL CAMINO REAL, INC.
Subdivision Name
Clinicas Del Camino Real, Inc. - Maravilla
Type
HRSA-Funded Health Center
340B ID
CH09365E
Entity Address
450 W.Clara Street
Oxnard, CA 93033-8363
Grant Number
H80CS00550
Participating Start Date
4/1/2008
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
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