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DSH050222C SHARP CHULA VISTA MEDICAL CENTER (Active)
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Main Details
Name
SHARP CHULA VISTA MEDICAL CENTER
Subdivision Name
Physical Therapy Outpatient
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050222C
Medicare Provider Number
050222
Outpatient Facility Provider Number
050222
Additional Details
Current Program Status
Active
Registration Date
7/3/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/29/2014
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Sharp Chula Vista Medical Center
MISHAL Abdulaziz AL-RAWAF, CFO
(619) 502-3664
Primary Contact
Sharp HealthCare
Zephyr T Skeets, 340B Specialist
(858) 499-2148
Addresses
Street Address
752 Medical Center Ct.
Suite #303
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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