340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
COSTCO WHOLESALE CORPORATION
DSH050225 Adventist Health Feather River
Print
Covered Entity Details
Entity Name
Adventist Health Feather River
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050225
Entity Address
5974 PENTZ ROAD
PARADISE, CA 95969
Medicare Provider Number
050225
Participating Start Date
10/1/2010
Last Recertification Date
8/30/2018
Entity Termination Date
7/1/2019
Pharmacy Details
Pharmacy Name
COSTCO WHOLESALE CORPORATION
Pharmacy Address
DBA: COSTCO PHARMACY #1011
2100 DR MARTIN LUTHER KING JR PKWY.
CHICO, CA 95928
Pharmacy Comments
Contract Details
Approval Date
12/5/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
DANIEL K. GORDON, VP FINANCE/CFO
(530) 876-7200
Contract Pharmacy Representative
Christopher Pierce, AVP Pharmacy Benefits
(425) 427-7986
Signed By Date
10/15/2012
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session