Contract Pharmacy Details

WALGREEN CO.
CH09107A SF COMMUNITY CLINIC CONSORTIUM

Covered Entity Details

Entity Name

SF COMMUNITY CLINIC CONSORTIUM

Subdivision Name

TOM WADDELL HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH09107A

Entity Address

50 Dr Tom Waddell Pl
SAN FRANCISCO, CA 94102

Grant Number

H80CS00049

Participating Start Date

7/1/1997

Last Recertification Date

1/31/2023

Entity Termination Date

4/1/2023

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #13668
1496 MARKET STREET
SAN FRANCISCO, CA 94102

Pharmacy Comments

Contract Details

Approval Date

5/24/2009

Contract Begin Date

5/24/2009

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/1/2020
Pharmacy closed

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

3/17/2009

340B Drug Pricing Program Database