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WALGREEN CO.
DSH050276C CONTRA COSTA REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
CONTRA COSTA REGIONAL MEDICAL CENTER
Subdivision Name
CONCORD HEALTH CENTER
Type
Disproportionate Share Hospital
340B ID
DSH050276C
Entity Address
CONCORD HEALTH CENTER
3052 WILLOW PASS ROAD
CONCORD, CA 94519-7600
Medicare Provider Number
050276
Outpatient Facility Provider Number
Participating Start Date
4/1/2007
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 15947
13691 SAN PABLO AVE
SAN PABLO, CA 94806
Pharmacy Comments
Contract Details
Approval Date
7/1/2008
Contract Begin Date
7/1/2008
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
6/11/2008
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