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WALGREEN CO.
DSH050013 St. Helena Hospital, DBA Adventist Health St. Helena
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Covered Entity Details
Entity Name
St. Helena Hospital, DBA Adventist Health St. Helena
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050013
Entity Address
10 WOODLAND ROAD
ST. HELENA, CA 94574
Medicare Provider Number
050013
Participating Start Date
4/1/2010
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11822
1685 TRANCAS ST.
NAPA, CA 94558
Pharmacy Comments
Contract Details
Approval Date
1/11/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Steven Herber, CEO
(707) 963-6433
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/11/2021
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