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WALGREEN CO.
DSH050276J CONTRA COSTA REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
CONTRA COSTA REGIONAL MEDICAL CENTER
Subdivision Name
EL CERRITO HEALTH CENTER
Type
Disproportionate Share Hospital
340B ID
DSH050276J
Entity Address
EL CERRITO HEALTH CENTER
988 OAK GROVE RD
CONCORD, CA 94518-3032
Medicare Provider Number
050276
Outpatient Facility Provider Number
Participating Start Date
4/1/2007
Last Recertification Date
9/8/2022
Entity Termination Date
10/1/2023
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
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
6/11/2008
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