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DSH050276R CONTRA COSTA REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
CONTRA COSTA REGIONAL MEDICAL CENTER
Subdivision Name
George and Cynthia Miller Wellness Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050276R
Medicare Provider Number
050276
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/30/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/5/2014
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
George and Cynthia Miller Wellness Center
25 Allen Street
Martinez, CA 94553
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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