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DSH050038C SANTA CLARA VALLEY MEDICAL CENTER (Active)
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Main Details
Name
SANTA CLARA VALLEY MEDICAL CENTER
Subdivision Name
SCVMC RENAL CARE CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050038C
Medicare Provider Number
050038
Outpatient Facility Provider Number
052305
Additional Details
Current Program Status
Active
Registration Date
1/14/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/4/2015
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
SCVMC
Narinder Singh, Director of Pharmacy
(408) 885-2300
Primary Contact
Santa Clara Valley Health and Hospital System
Jennefer Yoon, Assistant Director of Pharmacy
(408) 885-7636
Addresses
Street Address
2220 MOORPARK AVE
SAN JOSE, CA 95128-2813
Billing Address
Santa Clara Valley Medical Center
751 S Bascom Ave
San Jose, CA 95128
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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