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OWENS PHARMACY #3
DSH050280 MERCY MEDICAL CENTER, REDDING
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Covered Entity Details
Entity Name
MERCY MEDICAL CENTER, REDDING
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050280
Entity Address
2175 ROSALINE AVENUE
REDDING, CA 96001-6009
Medicare Provider Number
050280
Participating Start Date
4/1/2006
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
OWENS PHARMACY #3
Pharmacy Address
2975 EAST ST
ANDERSON, CA 96007
Pharmacy Comments
Contract Details
Approval Date
11/14/2012
Contract Begin Date
11/14/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/1/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tim Panks, CFO
(530) 225-6121
Contract Pharmacy Representative
Owens Health Care
John Friesen, President/CEO
(530) 246-1075
Signed By Date
9/27/2012
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