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CRESCENT HEALTHCARE, INC.
DSH050039 ENLOE MEDICAL CENTER
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Covered Entity Details
Entity Name
ENLOE MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050039
Entity Address
1531 ESPLANADE
CHICO, CA 95926
Medicare Provider Number
050039
Participating Start Date
1/1/2017
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
CRESCENT HEALTHCARE, INC.
Pharmacy Address
25901 INDUSTRIAL BLVD BLDG E
HAYWARD, CA 94545-2995
Pharmacy Comments
Contract Details
Approval Date
7/8/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/15/2019
Ownership change
Contacts
Covered Entity Signing Official
Kevin Woodward, VP/Chief Financial Officer
(530) 332-6733
Contract Pharmacy Representative
Option Care
Jenny Money, Senior Manager, Health Systems Programs
(773) 202-6786
Signed By Date
7/8/2019
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