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DSH050195 WASHINGTON HOSPITAL HEALTHCARE SYSTEM (Active)
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Main Details
Name
WASHINGTON HOSPITAL HEALTHCARE SYSTEM
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050195
Medicare Provider Number
050195
Additional Details
Current Program Status
Active
Registration Date
6/10/2010
Participating Start Date
7/1/2010
Participating Approval Date
6/15/2010
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Washington Hospital Healthcare System
Larry LaBossiere, SVP & COO
(510) 818-6586
Primary Contact
Washington Hospital Healthcare System
Minh-Thu Dennen, Director of Pharmacy
(510) 818-6114
Addresses
Street Address
2000 MOWRY AVENUE
FREMONT, CA 94538
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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