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CAH051328-00 TAHOE FOREST HOSPITAL (Active)
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Main Details
Name
TAHOE FOREST HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH051328-00
Medicare Provider Number
051328
Additional Details
Current Program Status
Active
Registration Date
11/11/2010
Participating Start Date
1/1/2011
Participating Approval Date
12/6/2010
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
TAHOE FOREST HOSPITAL DISTRICT
CRYSTAL BETTS, CHIEF FINANCIAL OFFICER
(530) 582-6656
Primary Contact
Tahoe Forest Hospital
Jim L Franckum, Director of Pharmacy
(530) 582-3430
Addresses
Street Address
10121 PINE AVENUE
TRUCKEE, CA 96161
Billing Address
TAHOE FOREST HOSPITAL DISTRICT
P.O. BOX 759
TRUCKEE, CA 96160
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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