Contract Pharmacy Details

WALGREEN CO.
CH092440 CLINIC INC, THE

Covered Entity Details

Entity Name

CLINIC INC, THE

Subdivision Name

T.H.E. CLINIC, INC.

Type

HRSA-Funded Health Center

340B ID

CH092440

Entity Address

3834 S. WESTERN AVE
LOS ANGELES, CA 90062-1104

Grant Number

H80CS00755

Participating Start Date

7/1/2003

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #15190
1399 ROXBURY DR
LOS ANGELES, CA 90035

Pharmacy Comments

Contract Details

Approval Date

10/9/2017

Contract Begin Date

1/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Clifford Shiepe, President and CEO
(323) 730-1920 Ext: 3053

Contract Pharmacy Representative

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

Signed By Date

10/9/2017

340B Drug Pricing Program Database