340B Drug Pricing Program Database
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DSH050485F Long Beach Memorial Medical Center, Inc. dba MemorialCare Long Beach Medical Center (Active)
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Main Details
Name
Long Beach Memorial Medical Center, Inc. dba MemorialCare Long Beach Medical Center
Subdivision Name
PET Scanning - PET Scanning
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050485F
Medicare Provider Number
050485
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/2/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/8/2024
Last Recertification Date
Contacts
Authorizing Official
Long Beach Medical Center
Blair Kent, Chief Executive Officer
(562) 933-1111
Primary Contact
Long Beach Medical Center & Millier Children's and Women's Hospital
Jennifer T Chang, Executive Director, Pharmacy Services
(562) 933-0282
Addresses
Street Address
2888 Long Beach Blvd
110
Long Beach, CA 90806
Billing Address
Long Beach Memorial Medical Center
17360 Brookhurst Street
Fountain Valley, CA 92708
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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