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WALGREEN CO.
CH101030 YAKIMA VALLEY FARM WORKERS CLINIC
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Covered Entity Details
Entity Name
YAKIMA VALLEY FARM WORKERS CLINIC
Subdivision Name
YVFWC - TOPPENISH
Type
HRSA-Funded Health Center
340B ID
CH101030
Entity Address
510 W 1st Ave
Toppenish, WA 98948-1564
Grant Number
H80CS00639
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 16259
17979 NE GLISAN ST
PORTLAND, OR 97230
Pharmacy Comments
Contract Details
Approval Date
2/22/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/9/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
JUAN CARLOS OLIVARES, CEO
(509) 865-5898 Ext: 2101
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2013
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