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DSH050196X CENTRAL VALLEY GENERAL HOSPITAL (Terminated)
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Main Details
Name
CENTRAL VALLEY GENERAL HOSPITAL
Subdivision Name
AHCC Healthy Beginings
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050196X
Medicare Provider Number
050196
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/10/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/22/2015
Last Recertification Date
8/27/2015
Termination Date
Termination Reason
1/1/2016
Loss of qualifying grant/support
Contacts
Authorizing Official
Adventist Health
David L. Larsen, SR VP CFO
(559) 537-0050
Primary Contact
Adventist Medical Center Hanford
John Choi, Director of Pharmacy
(559) 537-2204
Addresses
Street Address
1122 N Harris Street
Hanford, CA 93230
Billing Address
Central Valley General Hospital
1025 N. Douty Street
Hanford, CA 93230
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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