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WALGREEN CO.
FQHCLA048 County of Tulare
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Covered Entity Details
Entity Name
County of Tulare
Subdivision Name
Tulare County Health Services
Type
Health Center Program Look-Alike
340B ID
FQHCLA048
Entity Address
5957 S. Mooney Blvd
Visalia, CA 93277
Grant Number
LALCS00070
Participating Start Date
7/1/1996
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 02869
1407 N DINUBA BLVD
VISALIA, CA 93291
Pharmacy Comments
Contract Details
Approval Date
1/5/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/5/2018
Pharmacy closed
Contacts
Covered Entity Signing Official
JASON T. BRITT, DIRECTOR OF PUBLIC HEALTH
(559) 624-8481
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/5/2015
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