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WALGREEN CO.
DSH050276F CONTRA COSTA REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
CONTRA COSTA REGIONAL MEDICAL CENTER
Subdivision Name
BAY POINT FAMILY HEALTH CENTER
Type
Disproportionate Share Hospital
340B ID
DSH050276F
Entity Address
BAY POINT FAMILY HEALTH CENTER
215 PACIFICA AVE
BAY POINT, CA 94565-2904
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 # 02506
1150 MACDONALD AVE
RICHMOND, CA 94801
Pharmacy Comments
Contract Details
Approval Date
7/1/2008
Contract Begin Date
7/1/2008
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
6/11/2008
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