340B Drug Pricing Program Database

Name

MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT

Subdivision Name

VALLEYWISE COMPREHENSIVE CARE CENTER - PHOENIX / CONGESTIVE HEART FAILURE CLINIC 100301092

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH030022DU

Medicare Provider Number

030022

Outpatient Facility Provider Number

Current Program Status

Active

Registration Date

10/5/2018

Participating Start Date

10/9/2018

Participating Approval Date

10/9/2018

Last Recertification Date

8/26/2024

Authorizing Official

Maricopa County Special Health Care District
Michael White, Executive Vice President, Chief Clinical Officer
(602) 344-5503

Primary Contact

MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT DBA VALLEYWISE HEALTH
Alba Misty Vo, Director of Pharmacy
(602) 344-5253

Street Address

MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT DBA VALLEYWISE COMPREHENSIVE HEALTH CENTER - PHOENIX
2525 E ROOSEVELT ST
PHOENIX, AZ 85008-4948

Billing Address

MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT DBA VALLEYWISE HEALTH
2601 E ROOSEVELT ST
PHOENIX, AZ 85008-4948