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WALGREENS SPECIALTY PHARMACY, LLC
TB944037 SAN MATEO COUNTY HEALTH SERVICES
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Covered Entity Details
Entity Name
SAN MATEO COUNTY HEALTH SERVICES
Subdivision Name
Public Health, Policy and Planning, TB Control
Type
Tuberculosis
340B ID
TB944037
Entity Address
225 WEST 37TH AVENUE
C/o PHPP TB Control Program
Building A, Floor 2
SAN MATEO, CA 94403
Grant Number
5NU52PS910219
Participating Start Date
7/1/1996
Last Recertification Date
5/8/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
7/19/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/11/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Scott Morrow, Agency Medical Director, Health Officer
(650) 573-2519
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/19/2016
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