340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KOMOTO MEDICAL PHARMACY
DSH050036 BAKERSFIELD MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
BAKERSFIELD MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050036
Entity Address
420 34TH STREET
BAKERSFIELD, CA 93301
Medicare Provider Number
050036
Participating Start Date
9/9/2005
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
KOMOTO MEDICAL PHARMACY
Pharmacy Address
2110 TRUXTUN AVE
SUITE 100
BAKERSFIELD, CA 93301
Pharmacy Comments
Contract Details
Approval Date
12/21/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jon Van Boening, PRESIDENT
(661) 327-4647 Ext: 1808
Contract Pharmacy Representative
Komoto
Brian Komoto, President & CEO
(559) 734-2896
Signed By Date
12/21/2012
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session