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WALGREEN CO.
CH09167G VISTA COMMUNITY CLINIC
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Covered Entity Details
Entity Name
VISTA COMMUNITY CLINIC
Subdivision Name
VCC: Lake Elsinore
Type
HRSA-Funded Health Center
340B ID
CH09167G
Entity Address
30195 FRASER DR
LAKE ELSINORE, CA 92530-7006
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 #11653
1320 ENCINITAS BLVD
ENCINITAS, CA 92024
Pharmacy Comments
Contract Details
Approval Date
10/10/2024
Contract Begin Date
1/1/2025
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
10/10/2024
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