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WALGREEN CO.
FQHCLA247A HEALTH AND LIFE ORGANIZATION INC.
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Covered Entity Details
Entity Name
HEALTH AND LIFE ORGANIZATION INC.
Subdivision Name
SACRAMENTO COMMUNITY CLINIC - DEL PASO
Type
Health Center Program Look-Alike
340B ID
FQHCLA247A
Entity Address
2200 DEL PASO BLVD
SACRAMENTO, CA 95815
Grant Number
LALCS00018
Participating Start Date
4/1/2009
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15987
1020 29TH ST STE 140
SACRAMENTO, CA 95816
Pharmacy Comments
Contract Details
Approval Date
1/12/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JERRY T. BLIATOUT, CEO
(916) 428-3788 Ext: 4236
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/12/2024
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