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WALGREEN CO
HV00791B Tarzana Treatment Centers, Inc.
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Covered Entity Details
Entity Name
Tarzana Treatment Centers, Inc.
Subdivision Name
Type
Ryan White Part C
340B ID
HV00791B
Entity Address
7101 Baird Ave
Reseda, CA 91335
Grant Number
H76HA00791
Participating Start Date
1/1/2013
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #01813
18568 VENTURA BLVD
TARZANA, CA 91356
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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