340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
INFUSION CARE PHARMACY NORTH
DSH050485 Long Beach Memorial Medical Center, Inc. dba MemorialCare Long Beach Medical Center
Print
Covered Entity Details
Entity Name
Long Beach Memorial Medical Center, Inc. dba MemorialCare Long Beach Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050485
Entity Address
2801 ATLANTIC AVENUE
LONG BEACH, CA 90806
Medicare Provider Number
050485
Participating Start Date
7/1/2004
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
INFUSION CARE PHARMACY NORTH
Pharmacy Address
455 E COLUMBIA ST
SUITE 10
LONG BEACH, CA 90806
Pharmacy Comments
Contract Details
Approval Date
1/12/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/1/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John Bishop, Chief Executive Officer
(562) 933-1111
Contract Pharmacy Representative
Scott Preston, Director of Pharmacy
(562) 933-0328
Signed By Date
1/12/2015
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