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DSH050342G PIONEERS MEMORIAL HOSPITAL (Active)
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Main Details
Name
PIONEERS MEMORIAL HOSPITAL
Subdivision Name
Surgical Health at Pioneers
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050342G
Medicare Provider Number
050342
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/17/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/15/2017
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Pioneers Memorial Hospital
Carly Loper, Chief Financial Officer
(760) 351-3594
Primary Contact
Pioneers Memorial Hospital
John Paul Teague, Director of Pharmacy
(760) 351-3278
Addresses
Street Address
751 W Legion Road Suite 305
Brawley, CA 92227
Billing Address
Pioneers Memorial Healthcare District
207 W Legion Road
Brawley, CA 92227
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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