Contract Pharmacy Details

WALGREEN CO
DSH050276D CONTRA COSTA REGIONAL MEDICAL CENTER

Covered Entity Details

Entity Name

CONTRA COSTA REGIONAL MEDICAL CENTER

Subdivision Name

NORTH RICHMOND CENTER FOR HEALTH

Type

Disproportionate Share Hospital

340B ID

DSH050276D

Entity Address

NORTH RICHMOND CENTER FOR HEALTH
1501 FRED JACKSON WAY (FORMERLY 3RD ST.)
NORTH RICHMOND, CA 94801-1516

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 #09978
6570 LONE TREE WAY
BRENTWOOD, CA 94513

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

340B Drug Pricing Program Database