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DSH050239 GLENDALE ADVENTIST MEDICAL CENTER (Active)
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Main Details
Name
GLENDALE ADVENTIST MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050239
Medicare Provider Number
050239
Additional Details
Current Program Status
Active
Registration Date
10/17/2007
Participating Start Date
4/1/2005
Participating Approval Date
10/17/2007
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Adventist Health Glendale
Alice Issai, President
(818) 409-8301
Primary Contact
Adventist Health Glendale
Romic Eskandarian, Director Of Pharmacy
(818) 409-8437
Addresses
Street Address
1509 WILSON TERRACE
GLENDALE, CA 91206
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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