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WALGREEN CO.
CH090200 SOUTH CENTRAL FAMILY HEALTH CENTER
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Covered Entity Details
Entity Name
SOUTH CENTRAL FAMILY HEALTH CENTER
Subdivision Name
South Central Family Health Center Vernon Avenue Site
Type
HRSA-Funded Health Center
340B ID
CH090200
Entity Address
1111 E. Vernon Avenue
Los Angeles, CA 90011-3718
Grant Number
H80CS00265
Participating Start Date
7/1/2000
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16482
1902 MARENGO ST
UNITS 105 AND 106
LOS ANGELES, CA 90033
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard A Veloz, Chief Executive Officer
(323) 908-4245
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/12/2023
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