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DSH050678A ORANGE COAST MEMORIAL MEDICAL CENTER (Terminated)
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Main Details
Name
ORANGE COAST MEMORIAL MEDICAL CENTER
Subdivision Name
OP SERVICES-BREAST CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050678A
Medicare Provider Number
050678
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/15/2015
Last Recertification Date
8/25/2023
Termination Date
Termination Reason
4/1/2024
Never implemented the 340B Program
Contacts
Authorizing Official
Orange Coast Memorial Medical Center
Emily Marcus Randle, COO
(714) 378-7538
Primary Contact
Orange Coast Memorial Medical Center
Stanley Hill, DIRECTOR OF PHARMACY
(714) 378-7012
Addresses
Street Address
9900 TALBERT AVE
FOUNTAIN VALLEY, CA 92708-5153
Billing Address
Orange Coast Memorial Medical Center
9920 Talbert Ave
Fountain Valley, CA 92708
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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