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WALGREEN CO.
CHC08241-00 MISSION CITY COMMUNITY NETWORK
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Covered Entity Details
Entity Name
MISSION CITY COMMUNITY NETWORK
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CHC08241-00
Entity Address
15206 PARTHENIA STREET
NORTH HILLS, CA 91343
Grant Number
H80CS08241
Participating Start Date
7/1/2000
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA:WALGREENS #12576
15318 ROY ROGERS DR.
VICTORVILLE, CA 92394
Pharmacy Comments
Contract Details
Approval Date
7/13/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nik Gupta, CEO
(818) 895-3100
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/13/2016
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