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WALGREEN CO.
DSH050496 JOHN MUIR MEDICAL CENTER - CONCORD
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Covered Entity Details
Entity Name
JOHN MUIR MEDICAL CENTER - CONCORD
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050496
Entity Address
2540 EAST STREET
CONCORD, CA 94520
Medicare Provider Number
050496
Participating Start Date
1/1/2023
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03164
1800 CONCORD AVE
CONCORD, CA 94520
Pharmacy Comments
Contract Details
Approval Date
4/18/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Zach Harris, VP Ancillary Services
(808) 457-0157
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/18/2023
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