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DSH050038D SANTA CLARA VALLEY MEDICAL CENTER (Active)
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Main Details
Name
SANTA CLARA VALLEY MEDICAL CENTER
Subdivision Name
SANTA CLARA VALLEY MEDICAL CENTER - PACE CLINIC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050038D
Medicare Provider Number
050038
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
5/30/2018
Participating Start Date
7/1/2018
Participating Approval Date
6/1/2018
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
SCVMC
Narinder Singh, Director of Pharmacy
(408) 885-2300
Primary Contact
Santa Clara Valley Health and Hospital System
Jennefer Yoon, Assistant Director of Pharmacy
(408) 885-7636
Addresses
Street Address
2400 MOORPARK AVE STE 316
SAN JOSE, CA 95128-2604
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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