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DSH050039AM ENLOE MEDICAL CENTER (Active)
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Main Details
Name
ENLOE MEDICAL CENTER
Subdivision Name
Enloe Health Structural Heart & Valve Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050039AM
Medicare Provider Number
050039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/13/2025
Participating Start Date
4/1/2025
Participating Approval Date
1/23/2025
Last Recertification Date
Contacts
Authorizing Official
Enloe Medical Center
Kevin Woodward, VP/Chief Financial Officer
(530) 332-6733
Primary Contact
Enloe Medical Center
Renee Thacker, Director, Finance
(530) 332-7386
Addresses
Street Address
181 E. 7th Ave
Chico, CA 95926
Billing Address
Enloe Medical Center
1531 Esplanade
Chico, CA 95926
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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