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DSH050036 BAKERSFIELD MEMORIAL HOSPITAL (Active)
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Main Details
Name
BAKERSFIELD MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050036
Medicare Provider Number
050036
Additional Details
Current Program Status
Active
Registration Date
8/30/2005
Participating Start Date
9/9/2005
Participating Approval Date
8/31/2005
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Bakersfield Memorial Hospital
Ken Keller, President
(661) 541-0001
Primary Contact
Bakersfield Memorial Hospital
Jocelyn Stover, Director, Pharmacy
(661) 541-0484
Addresses
Street Address
420 34TH STREET
BAKERSFIELD, CA 93301
Billing Address
Dignity Health AP
3033 N. 3rd Avenune
Phoenix, AZ 85013
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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November 2024
November 2024
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