340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH050112 SANTA MONICA UCLAMC AND ORTHOPAEDIC HOSPITAL
Print
Covered Entity Details
Entity Name
SANTA MONICA UCLAMC AND ORTHOPAEDIC HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050112
Entity Address
1250 16TH STREET
SANTA MONICA, CA 90404-1249
Medicare Provider Number
050112
Participating Start Date
7/1/2009
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11735
16100 VENTURA BLVD
ENCINO, CA 91436
Pharmacy Comments
Contract Details
Approval Date
7/11/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Staton, CFO
(310) 267-9308
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/11/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session