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DSH050222J SHARP CHULA VISTA MEDICAL CENTER (Active)
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Main Details
Name
SHARP CHULA VISTA MEDICAL CENTER
Subdivision Name
Radiology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050222J
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
9/4/2014
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
769 Medical Center Ct.
Suite # 100
Chula Vista, CA 91911
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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