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DSH050128 TRI-CITY MEDICAL CENTER (Active)
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Main Details
Name
TRI-CITY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050128
Medicare Provider Number
050128
Additional Details
Current Program Status
Active
Registration Date
10/11/2018
Participating Start Date
1/1/2019
Participating Approval Date
10/16/2018
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Tri-City Medical Center
Janice Gurley, Chief Financial Officer
(760) 940-5605
Primary Contact
Tri-City Medical Center
Julie Ann Abraham, Director of Pharmacy
(760) 940-3018
Addresses
Street Address
4002 VISTA WAY
OCEANSIDE, CA 92056-4506
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating start date 7/1/2008; Termination date 10/1/2018; Reinstatement date 1/1/12019.
10/15/2018
April 2025
April 2025
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