340B Drug Pricing Program Database
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DSH050636 PALOMAR MEDICAL CENTER POWAY (PMC Poway) (Active)
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Main Details
Name
PALOMAR MEDICAL CENTER POWAY (PMC Poway)
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050636
Medicare Provider Number
050636
Additional Details
Current Program Status
Active
Registration Date
4/13/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/20/2015
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
Palomar Health
Diane Lynette Hansen, President & CEO
(760) 740-6395
Primary Contact
Palomar Health
Dondreia Gelios, District Director Pharmacy Services
(442) 281-1358
Addresses
Street Address
15615 POMERADO RD
POWAY, CA 92064-2405
Billing Address
Palomar Health
120 Craven Road
200
San Marcos, CA 92078
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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