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SEENA PHARMACY
DSH050159AB VENTURA COUNTY MEDICAL CENTER
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Covered Entity Details
Entity Name
VENTURA COUNTY MEDICAL CENTER
Subdivision Name
Pediatric Hematology-Oncology Clinic
Type
Disproportionate Share Hospital
340B ID
DSH050159AB
Entity Address
300 HILLMONT AVE, BLDG #340
#301
Ventura, CA 93003
Medicare Provider Number
050159
Outpatient Facility Provider Number
Participating Start Date
10/1/2013
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
SEENA PHARMACY
Pharmacy Address
BASSO PHARMACY, INC. DBA
3901 LAS POSAS RD STE 101
CAMARILLO, CA 93010-1505
Pharmacy Comments
Contract Details
Approval Date
10/16/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathleen Kellerhouse, Chief of Hospital Operations
(805) 652-6052
Contract Pharmacy Representative
Independent
Jasmine Razeghi, Owner
(805) 419-2686
Signed By Date
10/16/2014
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