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DSH050222E SHARP CHULA VISTA MEDICAL CENTER (Terminated)
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Main Details
Name
SHARP CHULA VISTA MEDICAL CENTER
Subdivision Name
Infusion Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050222E
Medicare Provider Number
050222
Outpatient Facility Provider Number
050222
Additional Details
Current Program Status
Terminated
Registration Date
7/3/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/29/2014
Last Recertification Date
8/19/2015
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
Sharp Chula Vista Medical Center
RICK KING, CFO
(619) 502-3664
Primary Contact
Sharp Healthcare
Besher Flores, 340B Program Specialist
(858) 499-4678
Addresses
Street Address
754 Medical Center Ct.
Chula Vista, CA 91911
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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