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DSH030013BK YUMA REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
YUMA REGIONAL MEDICAL CENTER
Subdivision Name
YRMC Outpatient Center - CT SCAN - PET CT
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030013BK
Medicare Provider Number
030013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/10/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/12/2024
Last Recertification Date
Contacts
Authorizing Official
Yuma Regional Medical Center
Vernon Moore, Chief Financial Officer
(928) 336-7015
Primary Contact
Yuma Regional Medical Center
Mark Jordan, Directory of Pharmacy
(928) 336-7815
Addresses
Street Address
1320 W. 24th Street
76620-10201100
Yuma, AZ 85364
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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