| Addresses | Shipping Address | Insert | Change Request | | Salinas Valley Health
450 E Romie Ln
Salinas, CA 93901 | 1/8/2025 7:43 AM |
| Details | Last Recertification Date | Update | Recertification | 9/5/2023 6:44:47 AM | 8/23/2024 4:10:22 PM | 8/23/2024 4:10 PM |
| Details | Entity Name | Update | Change Request | SALINAS VALLEY MEMORIAL HOSPITAL | SALINAS VALLEY HEALTH MEDICAL CENTER | 4/1/2024 6:15 AM |
| Contacts | Authorizing Official | Update | Change Request | Delgado, Pete
CEO
Salinas Valley Memorial Hospital
8317550741 | Radner, Allen
Interim President/CEO
Salinas Valley Memorial Hospital
8317550741 | 1/31/2024 8:24 AM |
| Contacts | Primary Contact | Update | Recertification | Danek, Mark
Director of Pharmacy
Salinas Valley Memorial Healthcare System
8317593234 | Miller, Clement
COO
Salinas Valley Health
8317550780 | 9/5/2023 6:44 AM |
| Details | Last Recertification Date | Update | Recertification | 8/29/2022 6:28:10 PM | 9/5/2023 6:44:47 AM | 9/5/2023 6:44 AM |
| Contacts | Primary Contact | Update | Recertification | Choi, John S
Director of Pharmacy
Salinas Valley Memorial Healthcare System
8317593234 | Danek, Mark
Director of Pharmacy
Salinas Valley Memorial Healthcare System
8317593234 | 8/29/2022 6:28 PM |
| Details | Last Recertification Date | Update | Recertification | 8/23/2021 1:52:01 PM | 8/29/2022 6:28:10 PM | 8/29/2022 6:28 PM |
| Details | Entity Name | Update | Change Request | SALINAS VALLEY MEMORIAL HEALTHCARE SYSTEM | SALINAS VALLEY MEMORIAL HOSPITAL | 7/26/2022 6:52 AM |
| Details | Last Recertification Date | Update | Recertification | 8/26/2020 8:10:59 AM | 8/23/2021 1:52:01 PM | 8/23/2021 1:52 PM |
| Contacts | Primary Contact | Update | Change Request | Lepley, Bruce Allen
Assistant Director of Pharmacy
Salinas Vallry Memorial Hospital
8317593090 | Choi, John S
Director of Pharmacy
Salinas Valley Memorial Healthcare System
8317593234 | 1/14/2021 4:13 PM |
| Medicaid Billing | NPI: Number | Insert | Recertification | | 1750384079 | 8/26/2020 8:10 AM |
| Medicaid Billing | NPI: State | Insert | Recertification | | CA | 8/26/2020 8:10 AM |
| Medicaid Billing | NPI: Number | Delete | Recertification | 1750384079 ( ) | | 8/26/2020 8:10 AM |
| Contacts | Primary Contact | Update | Recertification | Hurt, Alfred J.
Director of Pharmacy
Salinas Valley Memorial Hospital
8317593234 | Lepley, Bruce Allen
Assistant Director of Pharmacy
Salinas Vallry Memorial Hospital
8317593090 | 8/26/2020 8:10 AM |
| Details | Last Recertification Date | Update | Recertification | 8/21/2019 1:34:06 PM | 8/26/2020 8:10:59 AM | 8/26/2020 8:10 AM |
| Details | Last Recertification Date | Update | Recertification | 8/20/2018 2:38:09 PM | 8/21/2019 1:34:06 PM | 8/21/2019 1:34 PM |
| Details | Last Recertification Date | Update | Recertification | 11/30/2017 3:49:09 PM | 8/20/2018 2:38:09 PM | 8/20/2018 2:38 PM |
| Details | Entity Name | Update | Recertification | SALINAS VALLEY MEMORIAL HOSPITAL | SALINAS VALLEY MEMORIAL HEALTHCARE SYSTEM | 11/30/2017 4:19 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | Recertification | | False | 11/30/2017 3:49 PM |
| Medicaid Billing | Medicaid: Number | Insert | Recertification | | HSC0334F | 11/30/2017 3:49 PM |
| Medicaid Billing | Medicaid: State | Insert | Recertification | | CA | 11/30/2017 3:49 PM |
| Details | Last Recertification Date | Update | Recertification | 8/15/2016 12:00:00 AM | 11/30/2017 3:49:09 PM | 11/30/2017 3:49 PM |
| Contacts | Authorizing Official | Update | | Delgado, Pete
CEO
8317550741 | Delgado, Pete
CEO
Salinas Valley Memorial Hospital
8317550741 | 10/4/2017 2:39 PM |
| Contacts | Signed By | Update | | Delgado, Pete
CEO
8317550741 | Delgado, Pete
CEO
Salinas Valley Memorial Hospital
8317550741 | 10/4/2017 2:39 PM |
| Contacts | Primary Contact | Update | | Hurt, Alfred J.
Director of Pharmacy
8317593234 | Hurt, Alfred J.
Director of Pharmacy
Salinas Valley Memorial Hospital
8317593234 | 10/4/2017 2:03 PM |
| Contacts | Authorizing Official | Insert | | | Delgado, Pete
CEO
8317550741 | 2/15/2017 4:32 PM |
| Contacts | Signed By | Insert | | | Delgado, Pete
CEO
8317550741 | 2/15/2017 4:32 PM |
| Addresses | Main Address | Insert | | |
120 WILGART WAY
SUITE A
SALINAS, CA 93901-4098 | 2/15/2017 11:43 AM |
| Contacts | Primary Contact | Insert | | | Hurt, Alfred J.
Director of Pharmacy
8317593234 | 2/15/2017 11:43 AM |
| Details | Last Recertification Date | Update | | | 8/15/2016 12:00:00 AM | 8/19/2016 2:37 PM |
| Dates | Participating Approval Date | Update | | | 2/12/2016 12:00:00 AM | 2/12/2016 10:28 AM |
| Details | State | Update | | Pending | Active | 2/12/2016 10:28 AM |
| Dates | Start Date | Update | | | 4/1/2016 12:00:00 AM | 2/12/2016 10:28 AM |
| Details | 340B ID | Update | | OUTPATIENT_ONLINE_REG_56851 | DSH050334B | 1/11/2016 2:04 PM |
| Details | 340B ID | Update | | | OUTPATIENT_ONLINE_REG_56851 | 1/7/2016 4:41 PM |
| Medicaid Billing | NPI: Number | Insert | | | 1750384079 | 1/7/2016 4:41 PM |
| Details | Last Recertification Date | Insert | | | | 1/7/2016 4:41 PM |
| Details | Grant Number | Insert | | | | 1/7/2016 4:41 PM |
| Details | 340B ID | Insert | | | | 1/7/2016 4:41 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 1/7/2016 4:41 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 1/7/2016 4:41 PM |
| Details | Medicare Provider Number | Insert | | | 050334 | 1/7/2016 4:41 PM |
| Details | Entity Name | Insert | | | SALINAS VALLEY MEMORIAL HOSPITAL | 1/7/2016 4:41 PM |
| Details | Program Code | Insert | | | DSH | 1/7/2016 4:41 PM |
| Details | Entity Subname | Insert | | | SLEEP MEDICINE CENTER | 1/7/2016 4:41 PM |
| Dates | Participating Approval Date | Insert | | | | 1/7/2016 4:41 PM |
| Details | State | Insert | | | Pending | 1/7/2016 4:41 PM |
| Dates | Registration Date | Insert | | | 1/7/2016 12:00:00 AM | 1/7/2016 4:41 PM |
| Dates | Signed By Date | Insert | | | 1/7/2016 12:00:00 AM | 1/7/2016 4:41 PM |
| Dates | Start Date | Insert | | | | 1/7/2016 4:41 PM |
| Terminations | Termination Comments | Insert | | | | 1/7/2016 4:41 PM |
| Terminations | Termination Date | Insert | | | | 1/7/2016 4:41 PM |
| Terminations | Termination Effective Date | Insert | | | | 1/7/2016 4:41 PM |
| Terminations | Termination Reason | Insert | | | | 1/7/2016 4:41 PM |