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DSH050133C RIDEOUT MEMORIAL HOSPITAL DBA Adventist Health and Rideout (Terminated)
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Main Details
Name
RIDEOUT MEMORIAL HOSPITAL DBA Adventist Health and Rideout
Subdivision Name
FEATHER RIVER SURGERY CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050133C
Medicare Provider Number
050133
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/2/2018
Participating Start Date
7/2/2018
Participating Approval Date
7/2/2018
Last Recertification Date
8/30/2019
Termination Date
Termination Reason
10/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
Rideout Memorial Hospital
Ed Gonzalez, CFO
(530) 751-4010
Primary Contact
Rideout Health
Israel Camacho, 340B Program Coordinator
(559) 723-2514
Addresses
Street Address
370 DEL NORTE AVE
STE 101
YUBA CITY, CA 95991
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2011, terminated 4/1/2018. Reinstated 7/2/2018.
07/02/2018
May 2025
May 2025
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