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DSH050455C Adventist Health Bakersfield (Terminated)
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Main Details
Name
Adventist Health Bakersfield
Subdivision Name
OUT-PATIENT SURGERY CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050455C
Medicare Provider Number
050455
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/8/2014
Last Recertification Date
9/7/2021
Termination Date
Termination Reason
10/1/2022
Site closure
Contacts
Authorizing Official
Adventist Health
Shane H Cox, Finance Officer
(661) 869-6180
Primary Contact
Adventist Health Bakersfield
Dixit D Bhakta, Director of Pharmacy
(661) 863-3289
Addresses
Street Address
2620 CHESTER AVE
BAKERSFIELD, CA 93301-2015
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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