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DSH050568 MADERA COMMUNITY HOSPITAL (Terminated)
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Main Details
Name
MADERA COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050568
Medicare Provider Number
050568
Additional Details
Current Program Status
Terminated
Registration Date
2/6/2006
Participating Start Date
4/1/2006
Participating Approval Date
2/9/2006
Last Recertification Date
8/25/2022
Termination Date
Termination Reason
10/1/2023
DSH percentage below statutory minimum
Contacts
Authorizing Official
Madera Community Hospital
MARK FOOTE, VP FINANCE/CFO
(559) 675-5505
Primary Contact
Madera Community Hospital
Colton Pfister, Pharmacy Director
(559) 675-5543
Addresses
Street Address
1250 E ALMOND AVENUE
MADERA, CA 93637
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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