340B Drug Pricing Program Database
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CAH051309-00 JEROLD PHELPS COMMUNITY HOSPITAL (Active)
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Main Details
Name
JEROLD PHELPS COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH051309-00
Medicare Provider Number
051309
Additional Details
Current Program Status
Active
Registration Date
7/11/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/8/2016
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Southern Humboldt Community Healthcare District
Paul M. Eves, Chief Financial Officer
(707) 923-3921 Ext: 291
Primary Contact
Southern Humboldt Community Healthcare District
Jennifer Lin Gutierrez, Pharmacy Tech
(707) 923-3921 Ext: 270
Addresses
Street Address
733 CEDAR STREET
GARBERVILLE, CA 95542
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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