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WALGREEN CO.
DSH050152 UCSF HEALTH - ST. FRANCIS HOSPITAL
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Covered Entity Details
Entity Name
UCSF HEALTH - ST. FRANCIS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050152
Entity Address
900 HYDE STREET
SAN FRANCISCO, CA 94109
Medicare Provider Number
050152
Participating Start Date
10/1/2004
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 01626
2494 SAN BRUNO AVE
SAN FRANCISCO, CA 94134
Pharmacy Comments
Contract Details
Approval Date
1/14/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/25/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kecia Kelly, COO/CNO
(415) 353-6173
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/14/2020
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