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DSH030013H YUMA REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
YUMA REGIONAL MEDICAL CENTER
Subdivision Name
OB & Gynecology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030013H
Medicare Provider Number
030013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/2/2016
Last Recertification Date
8/25/2016
Termination Date
Termination Reason
4/1/2017
Site closure
Contacts
Authorizing Official
Yuma Regional Medical Center
David Willie, CFO
(928) 336-7015
Primary Contact
Yuma Regional Medical Center
Mark Jordan, Directory of Pharmacy
(928) 336-7815
Addresses
Street Address
845 B Street
San Luis, AZ 85349
Billing Address
Yuma Regional Medical Center
2400 S. Avenue A
Yuma, AZ 85364
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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