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WALGREEN CO.
STD944039 SAN MATEO COUNTY HEALTH SERVICES AGENCY
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Covered Entity Details
Entity Name
SAN MATEO COUNTY HEALTH SERVICES AGENCY
Subdivision Name
PHPP, STD Control and Prevention
Type
Sexually Transmitted Diseases
340B ID
STD944039
Entity Address
225 W 37TH AVENUE, Building A
c/o STD Control Program
230
SAN MATEO, CA 94403
Grant Number
1H25PS005127
Participating Start Date
1/1/1998
Last Recertification Date
5/8/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 02126
1414 EL CAMINO REAL
SAN CARLOS, CA 94070
Pharmacy Comments
Contract Details
Approval Date
7/18/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/12/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Anita Booker, Public Health Clinics Manager
(650) 573-2493
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/18/2016
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