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DSH050103 WHITE MEMORIAL MEDICAL CENTER, DBA Adventist Health White Memorial (Active)
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Main Details
Name
WHITE MEMORIAL MEDICAL CENTER, DBA Adventist Health White Memorial
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050103
Medicare Provider Number
050103
Additional Details
Current Program Status
Active
Registration Date
7/1/2005
Participating Start Date
7/1/2005
Participating Approval Date
5/16/2005
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
White Memorial Medical Center
Francis Christopher Owens, Finance Officer
(323) 268-5000 Ext: 14733
Primary Contact
White Memorial Medical Center
Prissilla Xu, Director of Pharmacy, interim
(323) 268-5000 Ext: 3330
Addresses
Street Address
1720 EAST CESAR E CHAVEZ AVENUE
LOS ANGELES, CA 90033
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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