340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH050761D TARZANA MEDICAL CENTER LLC DBA PROVIDENCE CEDARS SINAI TARZANA MEDICAL CENTER (Active)
Print
Main Details
Name
TARZANA MEDICAL CENTER LLC DBA PROVIDENCE CEDARS SINAI TARZANA MEDICAL CENTER
Subdivision Name
CENTER FOR CARDIAC REHABILITATION
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050761D
Medicare Provider Number
050761
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/7/2016
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Providence Cedars Tarzana Medical Center
Jessica Marie Trimble, Chief Financial Officer
(818) 401-4195
Primary Contact
Providence Cedars Sinai Tarzana Medical Center
Goorgen Boghossian, Director of Pharmacy
(818) 708-5413
Addresses
Street Address
18411 CLARK ST 200
TARZANA, CA 91356-3540
Billing Address
Providence Tarzana Medical Center
PO BOX 696430
San Antonio, TX 78269
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.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
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