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DSH050492 Fresno Community Hospital & Medical Center dba Clovis Community Medical Center (Active)
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Main Details
Name
Fresno Community Hospital & Medical Center dba Clovis Community Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050492
Medicare Provider Number
050492
Additional Details
Current Program Status
Active
Registration Date
10/3/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/26/2013
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Community Medical Center
Tracy Kiritani, VP Hospital Financial Operations
(559) 324-4844
Primary Contact
Community Medical Center
Marcela Magallon, 340B Manager
(559) 244-1387
Addresses
Street Address
2755 Herndon Avenue
Clovis, CA 93611
Billing Address
Community Regional Medical Center
P.O. Box 1232
Fresno, CA 93715-1231
Comments
Medicaid Billing
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Contract Pharmacies
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