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DSH050496 JOHN MUIR MEDICAL CENTER - CONCORD (Active)
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Main Details
Name
JOHN MUIR MEDICAL CENTER - CONCORD
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050496
Medicare Provider Number
050496
Additional Details
Current Program Status
Active
Registration Date
10/3/2022
Participating Start Date
1/1/2023
Participating Approval Date
12/2/2022
Last Recertification Date
8/18/2024
Contacts
Authorizing Official
John Muir Health
Zach Harris, VP Ancillary Services
(808) 457-0157
Primary Contact
John Muir Health
Nikolai Tyler Dahl, Program Manager - Medication Utilization
(925) 947-3243
Addresses
Street Address
2540 EAST STREET
CONCORD, CA 94520
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 7/1/2022, Terminated 10/1/2022, reinstating on 1/1/2023
12/02/2022
April 2025
April 2025
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