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CAH051305-00 MAYERS MEMORIAL HOSPITAL (Active)
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Main Details
Name
MAYERS MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH051305-00
Medicare Provider Number
051305
Additional Details
Current Program Status
Active
Registration Date
10/6/2020
Participating Start Date
1/1/2021
Participating Approval Date
12/8/2020
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Mayers Memorial Hospital District
Ryan Jay Ramon Harris, Chief Executive Officer
(530) 336-5511 Ext: 1190
Primary Contact
Mayers Memorial Hospital
KEITH Lemuel EARNEST, CCO
(530) 336-5554 Ext: 1153
Addresses
Street Address
43563 HIGHWAY 299 EAST
FALL RIVER MILLS, CA 96028
Billing Address
MAYERS MEMORIAL HOSPITAL
P.O. BOX 459
FALL RIVER MILLS, CA 96028
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (9/22/2010) until terminated effective date: (10/1/2016), reinstatement effective date: (01/01/2021)
12/03/2020
April 2025
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