Contract Pharmacy Details

WALGREEN CO.
CHC28978-00 ASIAN AND PACIFIC ISLANDER WELLNESS CENTER, INC.

Covered Entity Details

Entity Name

ASIAN AND PACIFIC ISLANDER WELLNESS CENTER, INC.

Subdivision Name

Asian and Pacific Islander Wellness Center

Type

HRSA-Funded Health Center

340B ID

CHC28978-00

Entity Address

726 POLK ST, 4th Floor
San Francisco, CA 94109-7812

Grant Number

H80CS28978

Participating Start Date

4/1/2016

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 02153
790 VAN NESS AVE
SAN FRANCISCO, CA 94102

Pharmacy Comments

Contract Details

Approval Date

10/4/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Lance Toma, Chief Executive Officer
(415) 292-3400 Ext: 355

Contract Pharmacy Representative

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

Signed By Date

10/4/2016

340B Drug Pricing Program Database