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CAH051304-00 JOHN C. FREMONT HEALTHCARE DISTRICT (Active)
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Main Details
Name
JOHN C. FREMONT HEALTHCARE DISTRICT
Subdivision Name
A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH051304-00
Medicare Provider Number
051304
Additional Details
Current Program Status
Active
Registration Date
10/18/2010
Participating Start Date
1/1/2011
Participating Approval Date
12/6/2010
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
John C Fremont Healthcare
Patricia Ryan, Interim CEO
(209) 966-3631
Primary Contact
Ms.
Kathy Blalock, RN
(209) 966-3631 Ext: 5057
Addresses
Street Address
5189 HOSPITAL RD
MARIPOSA, CA 95338-0216
Billing Address
JOHN C. FREMONT HEALTHCARE DISTRICT
P.O. BOX 216
MARIPOSA, CA 95338-0216
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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