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DSH050276U CONTRA COSTA REGIONAL MEDICAL CENTER (Active)
Main Details
Name
CONTRA COSTA REGIONAL MEDICAL CENTER
Subdivision Name
Kennedy High School - Family Practice/Dental
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050276U
Medicare Provider Number
050276
Outpatient Facility Provider Number
Contacts
Authorizing Official
Contra Costa Health
Patrick Godley, Chief Operating Officer and Chief Financial Officer
(925) 957-5405
Primary Contact
Contra Costa Health
Robert H De Cesare, Fiscal Manager
(925) 957-5429
Additional Details
Current Program Status
Active
Registration Date
10/6/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/13/2023
Last Recertification Date
Addresses
Street Address
4300 Cutting Blvd
Richmond, CA 94804
Billing Address
Contra Costa Regional Medical Center Outpatient Pharmacy
2500 Alhambra Ave
Building 1
Martinez, CA 94553-3156
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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