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HINA'S HOME CARE PHARMACY
DSH050455 Adventist Health Bakersfield
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Covered Entity Details
Entity Name
Adventist Health Bakersfield
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050455
Entity Address
2615 Chester Avenue
BAKERSFIELD, CA 93301
Medicare Provider Number
050455
Participating Start Date
4/1/2005
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
HINA'S HOME CARE PHARMACY
Pharmacy Address
9508 STOCKDALE HWY STE 130
BAKERSFIELD, CA 93311
Pharmacy Comments
Contract Details
Approval Date
8/29/2012
Contract Begin Date
8/29/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brent W. Soper, Chief Financial Officer
(661) 869-6180
Contract Pharmacy Representative
Sanjay Patel, Co-Owner
(661) 664-7979 Ext: 9
Signed By Date
7/24/2012
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