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DSH050039P ENLOE MEDICAL CENTER (Terminated)
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Main Details
Name
ENLOE MEDICAL CENTER
Subdivision Name
Specialty Clinic Enloe Women's Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050039P
Medicare Provider Number
050039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/6/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/21/2016
Last Recertification Date
8/17/2021
Termination Date
Termination Reason
4/1/2022
Other
Contacts
Authorizing Official
Enloe Medical Center
Kevin Woodward, VP/Chief Financial Officer
(530) 332-6733
Primary Contact
Enloe Medical Center
Jessica Snelling, Director of Finance
(530) 332-7009
Addresses
Street Address
1405 Magnolia Ave
A & B
Chico, CA 95926
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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10/21/16 Registered for starting date of 10/1/2016, but terminated 10/1/2016. Reinstated 1/1/2017.
10/21/2016
April 2025
April 2025
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