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CAH051315-00 TRINITY HOSPITAL (Terminated)
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Main Details
Name
TRINITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH051315-00
Medicare Provider Number
051315
Additional Details
Current Program Status
Terminated
Registration Date
7/8/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/8/2014
Last Recertification Date
8/22/2023
Termination Date
Termination Reason
1/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Mountain Communities Healthcare District
Jennifer Van Matre, Chief Financial Officer
(530) 623-5541 Ext: 3232
Primary Contact
Mountain Communities Healthcare District
Nikki Mitchell, Staff Accountant
(530) 623-5541 Ext: 3309
Addresses
Street Address
60 EASTER AVENUE
WEAVERVILLE, CA 96093
Billing Address
Mountain Communities Healthcare District
PO Box 1229
Weaverville, CA 96093
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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