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DSH050441EF STANFORD HEALTH CARE (Active)
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Main Details
Name
STANFORD HEALTH CARE
Subdivision Name
Head Neck Oncology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050441EF
Medicare Provider Number
050441
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/7/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/24/2016
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Stanford Health Care
Linda Hoff, CFO
(650) 497-0391
Primary Contact
Stanford Health Care
Jannice Tan, Pharmacy Business Analyst, 340B
(510) 919-7483
Addresses
Street Address
900 Blake Wilbur Dr
3rd Floor
W3000
Palo Alto, CA 94304
Billing Address
Stanford Health Care
300 Pasteur Drive
H0301
Palo Alto, CA 94305
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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