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CLONEY'S PRESCRIPTION PHARMACY
DSH050006 St. Joseph Health Northern California, LLC-DBA St. Joseph Hospital
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Covered Entity Details
Entity Name
St. Joseph Health Northern California, LLC-DBA St. Joseph Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050006
Entity Address
2700 DOLBEER STREET
EUREKA, CA 95501
Medicare Provider Number
050006
Participating Start Date
4/1/2009
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
CLONEY'S PRESCRIPTION PHARMACY
Pharmacy Address
2515 HARRISON AVENUE
EUREKA, CA 95501-3220
Pharmacy Comments
Contract Details
Approval Date
4/30/2012
Contract Begin Date
4/30/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/23/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jim Strong, VP Finance/CFO
(707) 445-8121 Ext: 7491
Contract Pharmacy Representative
Rich Spini, Owner
(707) 443-7053
Signed By Date
4/24/2012
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