340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ST MARY HEALTH VENTURES
DSH050191 ST. MARY MEDICAL CENTER
Print
Covered Entity Details
Entity Name
ST. MARY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050191
Entity Address
1050 LINDEN AVENUE
LONG BEACH, CA 90813-3393
Medicare Provider Number
050191
Participating Start Date
1/1/2017
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
ST MARY HEALTH VENTURES
Pharmacy Address
DBA MEDICAL MALL PHARMACY
1040 ELM AVE STE 104
LONG BEACH, CA 90813
Pharmacy Comments
Contract Details
Approval Date
4/13/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Leon Choiniere, Vice President/Chief Financial Officer
(562) 491-9191
Contract Pharmacy Representative
St Mary Medical Center
Catherine Hirokawa, Director of Pharmacy
(562) 491-9773
Signed By Date
4/13/2017
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