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WALGREEN CO.
DSH050152 UCSF HEALTH - ST. FRANCIS HOSPITAL
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Covered Entity Details
Entity Name
UCSF HEALTH - ST. FRANCIS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050152
Entity Address
900 HYDE STREET
SAN FRANCISCO, CA 94109
Medicare Provider Number
050152
Participating Start Date
10/1/2004
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04609
1301 MARKET STREET
SAN FRANCISCO, CA 94103
Pharmacy Comments
Contract Details
Approval Date
10/14/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/15/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Alan Fox, CFO
(415) 353-6600
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/14/2013
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