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DSH050485A Long Beach Memorial Medical Center, Inc. dba MemorialCare Long Beach Medical Center (Active)
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Main Details
Name
Long Beach Memorial Medical Center, Inc. dba MemorialCare Long Beach Medical Center
Subdivision Name
LBM Multi-Specialty Center - Adult specialty clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050485A
Medicare Provider Number
050485
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/11/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/20/2018
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Long Beach Medical Center
Blair Kent, Chief Executive Officer
(562) 933-1111
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
2865 Atlantic Ave, Suite 104
Long Beach, CA 90806
Billing Address
Long Beach Memorial Medical Center
2801 Atlantic Avenue
Long Beach, CA 90806
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
May 2025
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