340B Drug Pricing Program Database
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DSH050067 OAK VALLEY DISTRICT HOSPITAL (Terminated)
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Main Details
Name
OAK VALLEY DISTRICT HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050067
Medicare Provider Number
050067
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/8/2016
Last Recertification Date
8/21/2023
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Oak Valley Hospital District
Ann Croskrey, CFO
(209) 848-4104
Primary Contact
OVHD
Amanda Gutierrez, Health Information Supervisor
(209) 848-4158
Addresses
Street Address
350 SOUTH OAK STREET
OAKDALE, CA 95361
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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