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DSH050121 Adventist Medical Center (Active)
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Main Details
Name
Adventist Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050121
Medicare Provider Number
050121
Additional Details
Current Program Status
Active
Registration Date
11/23/2007
Participating Start Date
1/1/2008
Participating Approval Date
12/4/2007
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Adventist Health
Timothy Michael Haydock, CFO
(559) 537-0050
Primary Contact
Adventist Health
Ahmed Abukhazneh, Pharmacist, Charge
(559) 537-2190
Addresses
Street Address
115 mall drive
HANFORD, CA 93230
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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