340B Drug Pricing Program Database
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DSH050057S KAWEAH DELTA HEALTH CARE DISTRICT (Terminated)
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Main Details
Name
KAWEAH DELTA HEALTH CARE DISTRICT
Subdivision Name
KAWEAH DELTA SLEEP DISORDERS CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050057S
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
8/26/2019
Termination Date
Termination Reason
4/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
Kaweah Delta Health Care District
GARY K. HERBST, Chief Executive Officer
(559) 624-2330
Primary Contact
Kaweah Delta Health Care District
Catherine Abercrombie, Pharmacy Business Coordinator
(559) 624-4529
Addresses
Street Address
126 S. FLORAL ST
VISALIA, CA 93291
Billing Address
Kaweah Delta Health Care District
400 W. Mineral King Ave
Visalia, CA 93291
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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