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SELMA PHARMACY
DSH050192 Reedley Community Hospital dba Adventist Health Reedley
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Covered Entity Details
Entity Name
Reedley Community Hospital dba Adventist Health Reedley
Subdivision Name
Reedley Community Hospital
Type
Disproportionate Share Hospital
340B ID
DSH050192
Entity Address
372 W. Cypress Ave
Reedley, CA 93654
Medicare Provider Number
050192
Participating Start Date
10/1/2013
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
SELMA PHARMACY
Pharmacy Address
2132 HIGH ST
SELMA, CA 93662
Pharmacy Comments
Contract Details
Approval Date
7/18/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Timothy Michael Haydock, CFO
(559) 537-0050
Contract Pharmacy Representative
Selma Pharmacy Corp.
Shady DOUS, President
(559) 318-9646
Signed By Date
7/18/2022
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