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WALGREEN CO.
HV09088A COUNTY OF SANTA CRUZ HEALTH SERVICES
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Covered Entity Details
Entity Name
COUNTY OF SANTA CRUZ HEALTH SERVICES
Subdivision Name
Type
Ryan White Part C
340B ID
HV09088A
Entity Address
1080 EMELINE AVE
SANTA CRUZ, CA 95060
Grant Number
H76HA00153
Participating Start Date
7/1/2018
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #15108
201 FRONT ST.
SANTA CRUZ, CA 95060
Pharmacy Comments
Contract Details
Approval Date
7/7/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Giang T. Nguyen, Health Services Agency Director
(831) 454-4324
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/7/2015
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