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DSH050045A EL CENTRO REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
EL CENTRO REGIONAL MEDICAL CENTER
Subdivision Name
El Centro Regional Medical Center Outpatient Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050045A
Medicare Provider Number
050045
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2013
Participating Start Date
4/1/2013
Participating Approval Date
3/11/2013
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
ECRMC
David Momberg, CFO
(858) 208-7724
Primary Contact
EL CENTRO REGIONAL MEDICAL CENTER
Nghiem Ngoc Linh, pharmacist
(760) 339-7180
Addresses
Street Address
385 West Main Street
El Centro, CA 92243
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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