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WALGREEN CO
FQHCLA247C HEALTH AND LIFE ORGANIZATION, INC. (H.A.L.O.)
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Covered Entity Details
Entity Name
HEALTH AND LIFE ORGANIZATION, INC. (H.A.L.O.)
Subdivision Name
Sacramento Community Clinic - Del Paso Dental
Type
Health Center Program Look-Alike
340B ID
FQHCLA247C
Entity Address
2138 Del Paso Blvd
Sacramento, CA 95815-3002
Grant Number
LALCS00018
Participating Start Date
1/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #10716
250 FLORIN RD
SACRAMENTO, CA 95831
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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