340B Drug Pricing Program Database
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DSH050239C GLENDALE ADVENTIST MEDICAL CENTER (Active)
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Main Details
Name
GLENDALE ADVENTIST MEDICAL CENTER
Subdivision Name
Cancer Center / Infusion Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050239C
Medicare Provider Number
050239
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/15/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/23/2015
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Adventist Health Glendale
Alice Issai, President
(818) 409-8301
Primary Contact
Adventist Health Glendale
Romic Eskandarian, Director Of Pharmacy
(818) 409-8437
Addresses
Street Address
381 Merrill Ave
Glendale, CA 91206
Billing Address
Glendale Adventist Medical Center
1509 Wilson Terrace
Glendale, CA 91206
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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