340B Drug Pricing Program Database
WALGREEN CO.
DSH050084 ST JOSEPH'S MEDICAL CENTER - information as of 5/20/2025 2:02:22 AM
Covered Entity Details
Entity Name
ST JOSEPH'S MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050084
Entity Address
1800 N CALIFORNIA STREET
STOCKTON, CA 95204
Medicare Provider Number
050084
Participating Start Date
1/1/2005
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #15398
660 W. MARCH LANE
STOCKTON, CA 95207
Pharmacy Comments
Contract Details
Approval Date
7/24/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/11/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Doreen Hartmann, CFO
(209) 467-6442
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/24/2013
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