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DSH050060C COMMUNITY REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
COMMUNITY REGIONAL MEDICAL CENTER
Subdivision Name
CALIFORNIA CANCER CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050060C
Medicare Provider Number
050060
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/5/2008
Participating Start Date
10/1/2013
Participating Approval Date
9/15/2013
Last Recertification Date
8/23/2018
Termination Date
Termination Reason
4/1/2019
Site closure
Contacts
Authorizing Official
Community Medical Center
Tracy Kiritani, VP Hospital Financial Operations
(559) 324-4844
Primary Contact
Community Medical Center
Joel Weber, Director of Finance -Pharmacy and 340B
(559) 231-1504
Addresses
Street Address
7257 NORTH FRESNO STREET
FRESNO, CA 93720
Billing Address
Community Regional Medical Center
P.O. Box 1232
Fresno, CA 93715-1232
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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9/15/13 Enrolled 4/1/2008 and terminated 4/1/2012 at entity request. Ineligible from 4/1/2012 through 9/30/2013; reinstated effective 10/1/2013.
09/15/2013
May 2025
May 2025
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