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WALGREEN CO.
CH09167F VISTA COMMUNITY CLINIC
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Covered Entity Details
Entity Name
VISTA COMMUNITY CLINIC
Subdivision Name
VISTA COMMUNITY CLINIC MOBILE VAN
Type
HRSA-Funded Health Center
340B ID
CH09167F
Entity Address
1000 Vale Terrace Dr
Vista, CA 92084-5218
Grant Number
H80CS00282
Participating Start Date
4/1/2016
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05456
1510 N SANTA FE AVE
VISTA, CA 92083
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michele Lambert, CFO
(760) 216-5803
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2024
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