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WALGREEN CO
RWI92354A Loma Linda University
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Covered Entity Details
Entity Name
Loma Linda University
Subdivision Name
Infectious Disease
Type
Ryan White Part A
340B ID
RWI92354A
Entity Address
81 South Highland Springs Ave.
Suite 303
Beaumont, CA 92223
Grant Number
UT8HA33958
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #10420
42107 BIG BEAR BLVD
PO BOX 6995
BIG BEAR LAKE, CA 92315-1518
Pharmacy Comments
Contract Details
Approval Date
1/30/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Travis Losey, Vice President for Research Affairs
(909) 558-8544
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/14/2025
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