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DSH050057AN Kaweah Delta Health Care District DBA Kaweah Health (Active)
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Main Details
Name
Kaweah Delta Health Care District DBA Kaweah Health
Subdivision Name
Kaweah Health Urology - Urology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050057AN
Medicare Provider Number
050057
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/9/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/18/2024
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Kaweah Delta Health Care District DBA Kaweah Health
Gary K Herbst, Chief Executive Officer
(559) 624-2330
Primary Contact
Kaweah Delta Health Care District DBA Kaweah Health
Allison E Gonzalez, Pharmacy Business Manager
(559) 624-5328
Addresses
Street Address
325 South Willis Street
Visalia, CA 93291
Billing Address
Kaweah Delta Health Care District dba Kaweah Health - Visalia, CA
400 W. Mineral King Ave.
Visalia, CA 93291
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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