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WALGREEN CO.
CHC26610-00 HI-DESERT MEMORIAL HEALTH CARE DISTRICT
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Covered Entity Details
Entity Name
HI-DESERT MEMORIAL HEALTH CARE DISTRICT
Subdivision Name
Morongo Basin Community Health Center-SR
Type
HRSA-Funded Health Center
340B ID
CHC26610-00
Entity Address
6380 Split Rock Ave
Twentynine Palms, CA 92277
Grant Number
H80CS26610
Participating Start Date
7/1/2015
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06399
58133 29 PALMS HWY
YUCCA VALLEY, CA 92284
Pharmacy Comments
Contract Details
Approval Date
6/11/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
NORA MAUGHAN, EXECUTIVE DIRECTOR
(760) 366-6120
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
6/11/2015
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