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WALGREEN CO.
CHC28369-00 ST ANTHONY MEDICAL CENTERS
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Covered Entity Details
Entity Name
ST ANTHONY MEDICAL CENTERS
Subdivision Name
St. Anthony Medical Centers - Hollywood Site
Type
HRSA-Funded Health Center
340B ID
CHC28369-00
Entity Address
6368 HOLLYWOOD BLVD
LOS ANGELES, CA 90028-6320
Grant Number
H80CS28369
Participating Start Date
7/1/2016
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
W002 DBA: WALGREENS #15278
1501 VINE ST.
LOS ANGELES, CA 90028-7304
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
2/28/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Rita George, admin
(323) 469-5555
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/18/2016
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