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WALGREEN CO.
CH095380 Marin Community Clinic
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Covered Entity Details
Entity Name
Marin Community Clinic
Subdivision Name
Marin Community Clinic - Larkspur
Type
HRSA-Funded Health Center
340B ID
CH095380
Entity Address
5 Bon Air Road, Suite 117
Larkspur, CA 94939-1138
Grant Number
H80CS00343
Participating Start Date
10/1/2001
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15296
2262 MARKET ST
SAN FRANCISCO, CA 94114
Pharmacy Comments
Contract Details
Approval Date
4/12/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Farhan Fadoo, CEO
(415) 448-1500
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/12/2024
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