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DSH050039G ENLOE MEDICAL CENTER (Terminated)
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Main Details
Name
ENLOE MEDICAL CENTER
Subdivision Name
Enloe / Behavioral Health
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050039G
Medicare Provider Number
050039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/11/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/17/2016
Last Recertification Date
9/3/2020
Termination Date
Termination Reason
10/1/2021
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
560 COHASSET RD
CHICO, CA 95926-2212
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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10/17/16 Participated starting 10/1/2015, terminated 10/1/2016. Reinstated 1/1/2017.
10/17/2016
April 2025
April 2025
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