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DSH050060L COMMUNITY REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
COMMUNITY REGIONAL MEDICAL CENTER
Subdivision Name
Clinic-Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050060L
Medicare Provider Number
050060
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/8/2013
Participating Start Date
7/1/2013
Participating Approval Date
5/15/2013
Last Recertification Date
11/20/2017
Termination Date
Termination Reason
7/1/2018
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Community Medical Center
Tracy Kiritani, VP Hospital Financial Operations
(559) 324-4844
Primary Contact
Community Medical Center
Joel Weber, Director of Finance -Pharmacy and 340B
(559) 231-1504
Addresses
Street Address
290 N. Wayte Lane Suite 2300
Fresno, CA 93701
Billing Address
Community Regional Medical Center
P.O. Box 1232
Fresno, CA 93715-1231
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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