Contract Pharmacy Details

WALGREEN CO.
CH09107BM SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM

Covered Entity Details

Entity Name

SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM

Subdivision Name

Tenderloin Health Services, a program of HealthRIGHT360

Type

HRSA-Funded Health Center

340B ID

CH09107BM

Entity Address

330 ELLIS ST
SAN FRANCISCO, CA 94102-2735

Grant Number

H80CS00049

Participating Start Date

7/1/2008

Last Recertification Date

1/29/2019

Entity Termination Date

4/1/2020

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #04318
4129 18TH STREET
SAN FRANCISCO, CA 94114

Pharmacy Comments

Contract Details

Approval Date

10/17/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Vitka Eisen, CEO
(415) 762-1558

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

10/17/2016

340B Drug Pricing Program Database