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DSH050159I VENTURA COUNTY MEDICAL CENTER (Terminated)
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Main Details
Name
VENTURA COUNTY MEDICAL CENTER
Subdivision Name
Santa Paula Hospital
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050159I
Medicare Provider Number
050159
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
9/6/2007
Participating Start Date
7/1/2006
Participating Approval Date
9/6/2007
Last Recertification Date
9/7/2020
Termination Date
Termination Reason
1/1/2021
Other
Contacts
Authorizing Official
Ventura County Medical Center
John Fankhauser, Chief Executive Officer
(805) 652-6058
Primary Contact
Ventura County Medical Center
Beatriz Cachu, 340B Program Administrator
(805) 652-6159
Addresses
Street Address
825 North 10th St.
Santa Paula, CA 93060
Billing Address
VCMC Accounts Payable
800 S Victoria Ave; L4610
Ventura, CA 93009
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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ELIG 1/1/98-3/31/05 AT 1334 E MAIN ST ADDRESS, NOT ELIG 4/1/05 TO 6/30/06
09/06/2007
May 2025
May 2025
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