340B Drug Pricing Program Database
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DSH050057P Kaweah Delta Health Care District DBA Kaweah Health (Terminated)
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Main Details
Name
Kaweah Delta Health Care District DBA Kaweah Health
Subdivision Name
THERAPY SPECIALISTS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050057P
Medicare Provider Number
050057
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/2/2013
Participating Start Date
4/8/2013
Participating Approval Date
4/5/2013
Last Recertification Date
9/14/2020
Termination Date
Termination Reason
7/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Kaweah Delta Health Care District DBA Kaweah Health
Gary K Herbst, Chief Executive Officer
(559) 624-2330
Primary Contact
Kaweah Delta Health Care District DBA Kaweah Health
Jill C Anderson, Pharmacy Business Manager
(559) 624-5091
Addresses
Street Address
820 S Akers St, Suite 200
VISALIA, CA 93277-8309
Billing Address
Kaweah Delta Health Care District
400 W Mineral King Ave
Visalia, CA 93291-6237
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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