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WALGREEN CO.
DSH050228 Zuckerberg San Francisco General
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Covered Entity Details
Entity Name
Zuckerberg San Francisco General
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050228
Entity Address
1001 Potrero Ave
San Francisco, CA 94110
Medicare Provider Number
050228
Participating Start Date
7/1/1994
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05487
5300 3RD STREET
SAN FRANCISCO, CA 94124
Pharmacy Comments
Contract Details
Approval Date
7/11/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/27/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Roland Pickens, Director, San Francisco Health Network
(415) 554-2711
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/11/2016
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