340B Drug Pricing Program Database
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DSH050060AM COMMUNITY REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
COMMUNITY REGIONAL MEDICAL CENTER
Subdivision Name
SPECIAL SERVICES CLINIC - Ambulatory Care at Specialty Services Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050060AM
Medicare Provider Number
050060
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/2/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/12/2024
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Community Medical Center
Tracy Kiritani, VP Hospital Financial Operations
(559) 324-4844
Primary Contact
Community Medical Center
Joel Weber, Director of Finance -Pharmacy and 340B
(559) 231-1504
Addresses
Street Address
2315 E ILLINOIS AVE
FRESNO, CA 93701-2219
Billing Address
Community Regional Medical Center
P.O. Box 1232
Fresno, CA 93715-1231
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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