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DSH050678 ORANGE COAST MEMORIAL MEDICAL CENTER (Active)
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Main Details
Name
ORANGE COAST MEMORIAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050678
Medicare Provider Number
050678
Additional Details
Current Program Status
Active
Registration Date
1/28/2008
Participating Start Date
4/1/2014
Participating Approval Date
1/28/2008
Last Recertification Date
8/18/2024
Contacts
Authorizing Official
Orange Coast Memorial Medical Center
Emily Marcus Randle, COO
(714) 378-7538
Primary Contact
Orange Coast Memorial Medical Center
Stanley Hill, DIRECTOR OF PHARMACY
(714) 378-7012
Addresses
Street Address
9920 TALBERT AVENUE
FOUNTAIN VALLEY, CA 92708
Billing Address
ORANGE COAST MEMORIAL MEDICAL CENTER
PO Box 20892
Fountain Valley, CA 92728
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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03/14/14- CE reinstated starting 04/01/14, was participating 4/01/05 to 12/31/2009, not participating 1/1/2010 to 03/31/2014 due to DSH% falling below statutory minimum;
03/14/2014
April 2025
April 2025
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