340B Drug Pricing Program Database
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DSH050058 GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER (Active)
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Main Details
Name
GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050058
Medicare Provider Number
050058
Additional Details
Current Program Status
Active
Registration Date
8/23/2007
Participating Start Date
1/1/2005
Participating Approval Date
8/23/2007
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Glendale Memorial Hospital and Health Center
Kora Guoyavatin, CFO
(818) 502-2204
Primary Contact
Glendale Memorial Hospital & Health Center
Leslie Pech, Director of Pharmacy
(818) 502-2284
Addresses
Street Address
1420 SOUTH CENTRAL AVE
GLENDALE, CA 91204
Billing Address
Dignity Health AP
3033 North 3rd Ave
Phoenix, AZ 85013
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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