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WALGREEN CO.
FP919502 Operation Samahan Inc.
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Covered Entity Details
Entity Name
Operation Samahan Inc.
Subdivision Name
National City Clinic
Type
Family Planning (Title X only)
340B ID
FP919502
Entity Address
2743 Highland Avenue
National City, CA 91950-7410
Grant Number
FPHPA096061
Participating Start Date
7/1/2012
Last Recertification Date
5/12/2016
Entity Termination Date
4/1/2017
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11406
10512 MISSION GORGE RD
SANTEE, CA 92071-3146
Pharmacy Comments
Contract Details
Approval Date
7/14/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2017
Contacts
Covered Entity Signing Official
Carl I. Walters II, CEO
(844) 200-2426 Ext: 1020
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/14/2016
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