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PED053305-00 LUCILE PACKARD CHILDREN'S HOSPITAL (Active)
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Main Details
Name
LUCILE PACKARD CHILDREN'S HOSPITAL
Subdivision Name
Type
Children's Hospital
Rural
No
340B ID
PED053305-00
Medicare Provider Number
053305
Additional Details
Current Program Status
Active
Registration Date
1/15/2010
Participating Start Date
1/19/2010
Participating Approval Date
1/19/2010
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Lucile Packard Children's Hospital
Rishi Seth, Vice President of Operations
(650) 724-3951
Primary Contact
Lucile Packard Children's Hospital
Mindy Chuang, Pharmacy Finance Manager
(650) 736-4075
Addresses
Street Address
725 WELCH ROAD
PALO ALTO, CA 94304
Billing Address
LUCILE PACKARD CHILDREN'S HOSPITAL - ACCOUNTS PAYABLE
725 WELCH ROAD MC5553
PALO ALTO, CA 94304
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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