340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PED053309-15 Long Beach Memorial Medical Center, Inc., dba MemorialCare Miller Children's and Women's Hospital Long Beach (Terminated)
Print
Main Details
Name
Long Beach Memorial Medical Center, Inc., dba MemorialCare Miller Children's and Women's Hospital Long Beach
Subdivision Name
Food Allergy Clinic
Type
Children's Hospital
Rural
No
340B ID
PED053309-15
Medicare Provider Number
053309
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/4/2016
Last Recertification Date
8/26/2020
Termination Date
Termination Reason
4/1/2021
Site closure
Contacts
Authorizing Official
MemorialCare-Long Beach Medical Center, Miller Children's & Women's Hospital
Ikenna (Ike) Mmeje, Chief Operating Officer
(562) 933-1123
Primary Contact
Long Beach Medical Center & Millier Children's and Women's Hospital
Jennifer T Chang, Executive Director, Pharmacy Services
(562) 933-0282
Addresses
Street Address
2801 Atlantic Avenue
Long Beach, CA 90806-1428
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session