Contract Pharmacy Details

WALGREEN CO
CH090710 COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.

Covered Entity Details

Entity Name

COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.

Subdivision Name

NIPOMO COMMUNITY MEDICAL CENTER

Type

HRSA-Funded Health Center

340B ID

CH090710

Entity Address

150 TEJAS PL
NIPOMO, CA 93444-9123

Grant Number

H80CS00621

Participating Start Date

4/1/1996

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO

Pharmacy Address

DBA: WALGREENS
2370 E MAIN STREET
WOODLAND, CA 95776

Pharmacy Comments

Contract Details

Approval Date

1/11/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/20/2015
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

RONALD E. CASTLE, CEO
(805) 459-1835

Contract Pharmacy Representative

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

Signed By Date

1/9/2013

340B Drug Pricing Program Database