Covered Entity Details

DSH050225V Adventist Health Feather River (Terminated) - information as of 4/29/2025 11:57:56 PM

Main Details

Name

Adventist Health Feather River

Subdivision Name

Pulmonology

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH050225V

Medicare Provider Number

050225

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

7/14/2016

Participating Start Date

10/1/2016

Participating Approval Date

8/16/2016

Last Recertification Date

8/30/2018

Termination Date
Termination Reason

7/1/2019
Site closure

Contacts

Authorizing Official

Adventist Health Castle
Ryan Ashlock, CEO
(808) 263-5142

Primary Contact

Feather River Hospital
Heather Barber, Director of Pharmacy
(530) 876-7978

Addresses

Street Address

6480 Pentz Rd Suite C
Paradise, CA 95969

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
		1518940667

Shipping Addresses

Shipping Address 1

Feather River Hospital
5974 Pentz RD
Paradise, CA 95969

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH050225A	Child	DSH	Adventist Health Feather River	CANCER CENTER	5629 CANYON VIEW DRIVE	PARADISE	CA	Terminated
DSH050225B	Child	DSH	FEATHER RIVER HOSPITAL	PARADISE MIDWIFERY SERVICES	771 BUSCHMANN ROAD	PARADISE	CA	Terminated
DSH050225C	Child	DSH	Adventist Health Feather River	CHICO NURSE MIDWIFERY SERVICES	111 Raley Blvd Ste 220	CHICO	CA	Terminated
DSH050225D	Child	DSH	Adventist Health Feather River	Feather River Hospital Specialty Services	6009 Pentz RD	Paradise	CA	Terminated
DSH050225E	Child	DSH	Adventist Health Feather River	Feather River Hospital Canyon View Clinic	5734 Canyon View Dr	Paradise	CA	Terminated
DSH050225F	Child	DSH	Adventist Health Feather River	Feather River Hospital Feather River Health Center	5125 Skyway	Paradise	CA	Terminated
DSH050225G	Child	DSH	Adventist Health Feather River	Family Health Center	5730 Canyon View Dr	Paradise	CA	Terminated
DSH050225H	Child	DSH	Adventist Health Feather River	Feather River ENT	6161 Clark Road	Paradise	CA	Terminated
DSH050225J	Child	DSH	Adventist Health Feather River	Skyway Primary Care	111 Raley Blvd Ste 140	Chico	CA	Terminated
DSH050225K	Child	DSH	Adventist Health Feather River	Total Women's Health A	6283 Clark Rd	Paradise	CA	Terminated
DSH050225L	Child	DSH	FEATHER RIVER HOSPITAL	Feather River OB GYN Associates	771 Buschmann Rd	Paradise	CA	Terminated
DSH050225M	Child	DSH	Adventist Health Feather River	Anticoagulation Clinic	5910 Clark Rd	Paradise	CA	Terminated
DSH050225N	Child	DSH	Adventist Health Feather River	FEATHER RIVER SURGICAL ASSOCIATES	6460 PENTZ RD, STE A	PARADISE	CA	Terminated
DSH050225P	Child	DSH	Adventist Health Feather River	Paradise Primary Care	6585 Clark Rd Suite 400	Paradise	CA	Terminated
DSH050225Q	Child	DSH	Adventist Health Feather River	Total Women's Health B	6283 Clark RD Ste 8	Paradise	CA	Terminated
DSH050225R	Child	DSH	Adventist Health Feather River	Paradise Surgical Associates	6480 Pentz Rd Suite A	Paradise	CA	Terminated
DSH050225S	Child	DSH	Adventist Health Feather River	Corning Health Center	155 Solano St	Corning	CA	Terminated
DSH050225T	Child	DSH	Adventist Health Feather River	Feather River Outpatient Center	1933 Peach Lane	Paradise	CA	Terminated
DSH050225U	Child	DSH	Adventist Health Feather River	Chico Specialty Health and Diagnostics Center	111 Raley Blvd Suite 160	Chico	CA	Terminated
DSH050225V	Child	DSH	Adventist Health Feather River	Pulmonology	6480 Pentz Rd Suite C	Paradise	CA	Terminated
DSH050225W	Child	DSH	Adventist Health Feather River	Feather River Women's Health Chico / Gynecology	111 Raley Blvd Suite 240	Chico	CA	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Change Request	Ashlock, Ryan CFO Feather River Hospital 5308767112	Ashlock, Ryan CEO Adventist Health Castle 8082635142	7/8/2022 10:45 PM
Details	State	Update		To Be Terminated	Terminated	7/1/2019 12:05 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		5/7/2019 12:00:00 AM	5/19/2019 11:03 AM
Details	State	Update	Termination Request	Active	To Be Terminated	5/19/2019 11:03 AM
Terminations	Termination Comments	Update	Termination Request		Entity not operating at this time -closure due to fire	5/19/2019 11:03 AM
Terminations	Termination Date	Update	Termination Request		7/1/2019 12:00:00 AM	5/19/2019 11:03 AM
Terminations	Termination Effective Date	Update	Termination Request		5/7/2019 12:00:00 AM	5/19/2019 11:03 AM
Terminations	Termination Reason	Update	Termination Request		Site closure	5/19/2019 11:03 AM
Addresses	Main Address	Update	Recertification	6460 Pentz Rd suite B Paradise, CA 95969	6480 Pentz Rd Suite C Paradise, CA 95969	8/30/2018 1:22 PM
Details	Last Recertification Date	Update	Recertification	11/20/2017 2:46:21 PM	8/30/2018 1:22:22 PM	8/30/2018 1:22 PM
Details	Entity Subname	Update	Recertification	Adventist Health Feather River	Pulmonology	8/30/2018 1:22 PM
Details	Entity Name	Update	Recertification	FEATHER RIVER HOSPITAL	Adventist Health Feather River	11/20/2017 3:16 PM
Details	Last Recertification Date	Update	Recertification		11/20/2017 2:46:21 PM	11/20/2017 2:46 PM
Details	Entity Subname	Update	Recertification	Feather River Pulmonology	Adventist Health Feather River	11/20/2017 2:46 PM
Contacts	Authorizing Official	Update		Ashlock, Ryan CFO 5308767112	Ashlock, Ryan CFO Feather River Hospital 5308767112	11/20/2017 12:56 PM
Contacts	Primary Contact	Update		Barber, Heather Director of Pharmacy 5308767978	Barber, Heather Director of Pharmacy Feather River Hospital 5308767978	9/27/2017 12:44 PM
Contacts	Authorizing Official	Insert			Ashlock, Ryan CFO 5308767112	8/10/2017 8:14 AM
Contacts	Primary Contact	Update		Young, Shirley Director PFS 5308767911	Barber, Heather Director of Pharmacy 5308767978	8/10/2017 8:14 AM
Contacts	Signed By	Insert			Kemske, Gary J. CFO 5308767200	8/3/2017 4:21 PM
Addresses	Main Address	Insert			6460 Pentz Rd suite B Paradise, CA 95969	8/3/2017 4:21 PM
Addresses	Shipping Address	Insert			Feather River Hospital 5974 Pentz RD Paradise, CA 95969	8/3/2017 4:21 PM
Contacts	Primary Contact	Insert			Young, Shirley Director PFS 5308767911	7/24/2017 4:50 PM
Dates	Participating Approval Date	Update			8/16/2016 12:00:00 AM	8/16/2016 11:00 AM
Details	State	Update		Pending	Active	8/16/2016 11:00 AM
Dates	Start Date	Update			10/1/2016 12:00:00 AM	8/16/2016 11:00 AM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_71744	DSH050225V	8/1/2016 1:35 PM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_71744	7/14/2016 2:27 PM
Medicaid Billing	NPI: Number	Insert			1518940667	7/14/2016 2:27 PM
Details	Last Recertification Date	Insert				7/14/2016 2:27 PM
Details	Grant Number	Insert				7/14/2016 2:27 PM
Details	340B ID	Insert				7/14/2016 2:27 PM
Details	Is Authorizing Official EHB Data	Insert				7/14/2016 2:27 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/14/2016 2:27 PM
Details	Medicare Provider Number	Insert			050225	7/14/2016 2:27 PM
Details	Entity Name	Insert			FEATHER RIVER HOSPITAL	7/14/2016 2:27 PM
Details	Program Code	Insert			DSH	7/14/2016 2:27 PM
Details	Entity Subname	Insert			Feather River Pulmonology	7/14/2016 2:27 PM
Dates	Participating Approval Date	Insert				7/14/2016 2:27 PM
Details	State	Insert			Pending	7/14/2016 2:27 PM
Dates	Registration Date	Insert			7/14/2016 12:00:00 AM	7/14/2016 2:27 PM
Dates	Signed By Date	Insert			7/14/2016 12:00:00 AM	7/14/2016 2:27 PM
Dates	Start Date	Insert				7/14/2016 2:27 PM
Terminations	Termination Comments	Insert				7/14/2016 2:27 PM
Terminations	Termination Date	Insert				7/14/2016 2:27 PM
Terminations	Termination Effective Date	Insert				7/14/2016 2:27 PM
Terminations	Termination Reason	Insert				7/14/2016 2:27 PM