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DSH050039AN ENLOE MEDICAL CENTER (Approved)
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Main Details
Name
ENLOE MEDICAL CENTER
Subdivision Name
Enloe Advanced Imaging - Springfield Drive
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050039AN
Medicare Provider Number
050039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/15/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/21/2025
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
1555 Springfield Dr.
Chico, CA 95928
Billing Address
Enloe Health
1531 Esplanade
Chico, CA 95926
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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