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DSH030022 MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT (Active)
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Main Details
Name
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030022
Medicare Provider Number
030022
Additional Details
Current Program Status
Active
Registration Date
10/1/2018
Participating Start Date
10/4/2018
Participating Approval Date
10/4/2018
Last Recertification Date
8/24/2024
Contacts
Authorizing Official
Maricopa County Special Health Care District
Michael White, Executive Vice President, Chief Clinical Officer
(602) 344-5503
Primary Contact
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT DBA VALLEYWISE HEALTH
Alba Misty Vo, Director of Pharmacy
(602) 344-5253
Addresses
Street Address
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT DBA VALLEYWISE HEALTH
2601 EAST ROOSEVELT STREET
PHOENIX, AZ 85008
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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