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WALGREEN CO
CH09123C LA CLINICA DE LA RAZA, INC.
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Covered Entity Details
Entity Name
LA CLINICA DE LA RAZA, INC.
Subdivision Name
LA CLINICA PITTSBURG - MEDICAL
Type
HRSA-Funded Health Center
340B ID
CH09123C
Entity Address
2240 Gladstone Dr STE 4
Pittsburg, CA 94565-5126
Grant Number
H80CS00631
Participating Start Date
10/1/2000
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #09978
6570 LONE TREE WAY
BRENTWOOD, CA 94513
Pharmacy Comments
Contract Details
Approval Date
10/4/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jane Garcia, CEO
(510) 535-4000
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/4/2023
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