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WALGREEN CO.
DSH050276B CONTRA COSTA REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
CONTRA COSTA REGIONAL MEDICAL CENTER
Subdivision Name
PITTSBURG HEALTH CENTER
Type
Disproportionate Share Hospital
340B ID
DSH050276B
Entity Address
PITTSBURG HEALTH CENTER
2311 LOVERIDGE ROAD
PITTSBURG, CA 94565-5117
Medicare Provider Number
050276
Outpatient Facility Provider Number
Participating Start Date
4/1/1998
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04724
3416 DEER VALLEY RD.
ANTIOCH, CA 94531-6650
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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