Contract Pharmacy Details

WALGREEN CO.
FQHCLA320 DESERT AIDS PROJECT INC.

Covered Entity Details

Entity Name

DESERT AIDS PROJECT INC.

Subdivision Name

Desert AIDS Project, Inc.

Type

Health Center Program Look-Alike

340B ID

FQHCLA320

Entity Address

1695 N Sunrise Way
Palm Springs, CA 92262-3701

Grant Number

LALCS00125

Participating Start Date

1/1/2014

Last Recertification Date

3/2/2015

Entity Termination Date

4/1/2016

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #13435
555 S SUNRISE WAY STE 112-113
PALM SPRINGS, CA 92264

Pharmacy Comments

Contract Details

Approval Date

11/18/2013

Contract Begin Date

1/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2016
Covered Entity Terminated

Contacts

Covered Entity Signing Official

David Brinkman, Chief Executive Officer
(760) 992-0418

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

10/11/2013

340B Drug Pricing Program Database