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WALGREEN CO.
URB12040A Urban Indian Health Board DBA Native American Health Center
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Covered Entity Details
Entity Name
Urban Indian Health Board DBA Native American Health Center
Subdivision Name
San Francisco Clinic
Type
Urban Indian
340B ID
URB12040A
Entity Address
160 Capp Street
San Francisco, CA 94110
Grant Number
Participating Start Date
10/1/2013
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #04318
4129 18TH STREET
SAN FRANCISCO, CA 94114
Pharmacy Comments
Contract Details
Approval Date
10/7/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ana O'Connor, Chief Operating Officer
(510) 434-5470
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/7/2013
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