Contract Pharmacy Details

WALGREEN CO.
DSH050030 OROVILLE HOSPITAL

Covered Entity Details

Entity Name

OROVILLE HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH050030

Entity Address

2767 OLIVE HIGHWAY
OROVILLE, CA 95966

Medicare Provider Number

050030

Participating Start Date

7/1/2006

Last Recertification Date

8/16/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06141
2703 ORO DAM BLVD E
OROVILLE, CA 95966

Pharmacy Comments

Contract Details

Approval Date

7/14/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

ASHOK P. KHANCHANDANI, EXECUTIVE VICE PRESIDENT/CFO
(530) 532-8509

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

7/14/2016

340B Drug Pricing Program Database