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WALGREEN CO.
RWI935342 TARZANA TREATMENT CENTERS, INC.
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Covered Entity Details
Entity Name
TARZANA TREATMENT CENTERS, INC.
Subdivision Name
HIV CLINIC
Type
Ryan White Part A
340B ID
RWI935342
Entity Address
907 W. LANCASTER BLVD
LANCASTER, CA 93534
Grant Number
H76HA00791
Participating Start Date
7/1/2011
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06018
831 E AVENUE K
LANCASTER, CA 93535
Pharmacy Comments
Contract Details
Approval Date
4/10/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ALBERT M. SENELLA, PRESIDENT AND CEO
(818) 654-3815
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/10/2014
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