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DSH050231 POMONA VALLEY HOSPITAL MEDICAL CENTER (Active)
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Main Details
Name
POMONA VALLEY HOSPITAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050231
Medicare Provider Number
050231
Additional Details
Current Program Status
Active
Registration Date
11/27/2006
Participating Start Date
1/1/2007
Participating Approval Date
11/28/2006
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Pomona Valley Hospital Medical Center
Darlene Scafiddi, Executive Vice President Chief Operating Officer
(909) 865-9879
Primary Contact
Pomona Valley Hospital Medical Center
Clifford Hiroshige, Director of Pharmacy
(909) 865-9656
Addresses
Street Address
1798 NORTH GAREY AVENUE
POMONA, CA 91767
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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