Contract Pharmacy Details

WALGREEN CO.
CHC10608-16 CENTRAL CITY COMMUNITY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

CENTRAL CITY COMMUNITY HEALTH CENTER, INC.

Subdivision Name

Central City Community Health Center - 57th & Broadway

Type

HRSA-Funded Health Center

340B ID

CHC10608-16

Entity Address

5715 S. Broadway
Los Angeles, CA 90037-4131

Grant Number

H80CS10608

Participating Start Date

4/1/2016

Last Recertification Date

2/24/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #12913
1500 E GAGE AVE
LOS ANGELES, CA 90001

Pharmacy Comments

Contract Details

Approval Date

10/13/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Sommer R Kaskowitz, Chief Nursing Officer
(323) 724-0019 Ext: 1026

Contract Pharmacy Representative

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

Signed By Date

10/13/2023

340B Drug Pricing Program Database