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DSH050348CE UCI MEDICAL CENTER (Terminated)
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Main Details
Name
UCI MEDICAL CENTER
Subdivision Name
UCI GOTTSCHALK MEDICAL PLAZA
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050348CE
Medicare Provider Number
050348
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/23/2015
Last Recertification Date
8/29/2024
Termination Date
Termination Reason
1/1/2025
Other
Contacts
Authorizing Official
UCI Health
Chad Thurman Lefteris, CEO
(714) 714-1423
Primary Contact
UCI Health
Melanie Joe, Chief Pharmacy Officer
(714) 456-5514
Addresses
Street Address
1 MEDICAL PLAZA DRIVE
IRVINE, CA 92697-0001
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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