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DSH050276M CONTRA COSTA REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
CONTRA COSTA REGIONAL MEDICAL CENTER
Subdivision Name
Mobile Clinic Vans
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050276M
Medicare Provider Number
050276
Outpatient Facility Provider Number
050276
Additional Details
Current Program Status
Active
Registration Date
10/10/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/17/2013
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Contra Costa Health Services
Brian Buchanan, Interim Chief Financial Officer
(925) 957-5410
Primary Contact
Contra Costa Health
Robert H De Cesare, Fiscal Manager
(925) 957-5429
Addresses
Street Address
Mobile Clinic Vans
202 Glacier Drive
Martinez, CA 94553-4826
Billing Address
Contra Costa Regional Medical Center Outpatient Pharmacy
2500 Alhambra Ave
Building 1
Martinez, CA 94553-3156
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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