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OWENS PHARMACY #5
DSH050042 ST ELIZABETH COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
ST ELIZABETH COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050042
Entity Address
2550 SISTER MARY COLUMBA
RED BLUFF, CA 96080
Medicare Provider Number
050042
Participating Start Date
1/1/2005
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
OWENS PHARMACY #5
Pharmacy Address
434 WALNUT STREET
RED BLUFF, CA 96080
Pharmacy Comments
Contract Details
Approval Date
11/14/2012
Contract Begin Date
11/14/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tim Panks, CFO
(530) 225-6121
Contract Pharmacy Representative
Owens Health Care
John Friesen, President/CEO
(530) 246-1075
Signed By Date
9/28/2012
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