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DSH030016 Banner Casa Grande Medical Center (Active)
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Main Details
Name
Banner Casa Grande Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030016
Medicare Provider Number
030016
Additional Details
Current Program Status
Active
Registration Date
7/1/2013
Participating Start Date
10/1/2013
Participating Approval Date
7/9/2013
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Banner Casa Grande Medical Center
Louis Schroeder, Chief Financial Officer
(520) 381-6529
Primary Contact
Banner Casa Grande Medical Center
Pamella L Martin, Director of Pharmacy
(520) 381-6506
Addresses
Street Address
1800 East Florence Blvd.
Casa Grande, AZ 85122
Billing Address
Banner Health Accounts Payable
PO Box 2977
Phoenix, AZ 85062
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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