340B Drug Pricing Program Database
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DSH050485E 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
TCI SPECIALTY CLINIC - 2ND FLOOR
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050485E
Medicare Provider Number
050485
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/4/2021
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
2810 Long Beach Blvd
Long Beach, CA 90806
Billing Address
Long Beach Memorial Medical Center
2801 Atlantic Av
Long Beach, CA 90806
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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