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DSH050276H CONTRA COSTA REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
CONTRA COSTA REGIONAL MEDICAL CENTER
Subdivision Name
CONTRA COSTA REGIONAL MEDICAL CENTER CLINIC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050276H
Medicare Provider Number
050276
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/28/2007
Participating Start Date
4/1/2007
Participating Approval Date
3/1/2007
Last Recertification Date
11/30/2017
Termination Date
Termination Reason
10/1/2018
Other
Contacts
Authorizing Official
Contra Costa Health Services
PATRICK GODLEY, COO & CFO
(925) 957-5405
Primary Contact
Contra Costa Health Services
Bud De Cesare, FISCAL MANAGER
(925) 957-5429
Addresses
Street Address
CONTRA COSTA REGIONAL MEDICAL CENTER CLINIC
2500 ALHAMBRA AVE
MARTINEZ, CA 94553-3156
Billing Address
CONTRA COSTA REGIONAL MEDICAL CENTER
HEALTH SERVICES FINANCE ADMINISTRATION
50 DOUGLAS DRIVE, SUITE 310
MARTINEZ, CA 94553-4098
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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