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WALGREEN CO.
RWI92614 AIDS Services Foundation Orange County dba Radiant Health Centers
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Covered Entity Details
Entity Name
AIDS Services Foundation Orange County dba Radiant Health Centers
Subdivision Name
Type
Ryan White Part A
340B ID
RWI92614
Entity Address
17982 Sky Park Circle
Suite J
Irvine, CA 92614
Grant Number
H89HA00019
Participating Start Date
7/1/2018
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09089
19001 BROOKHURST STREET
HUNTINGTON BEACH, CA 92646
Pharmacy Comments
Contract Details
Approval Date
1/14/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Philip Yaeger, Executive Director/CEO
(949) 809-5705
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/14/2016
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