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HOPE PHARMACY
DSH050045 EL CENTRO REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
EL CENTRO REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050045
Entity Address
1415 ROSS AVENUE
EL CENTRO, CA 92243
Medicare Provider Number
050045
Participating Start Date
10/1/2006
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
HOPE PHARMACY
Pharmacy Address
420 HEFFERNAN AVE STE A
CALEXICO, CA 92231-4718
Pharmacy Comments
Contract Details
Approval Date
5/23/2011
Contract Begin Date
5/23/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
5/19/2011
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