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DSH050060V COMMUNITY REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
COMMUNITY REGIONAL MEDICAL CENTER
Subdivision Name
Community Outpatient Oncology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050060V
Medicare Provider Number
050060
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/6/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/8/2017
Last Recertification Date
11/20/2017
Termination Date
Termination Reason
10/1/2018
Site closure
Contacts
Authorizing Official
Community Medical Center
Tracy Kiritani, VP Hospital Financial Operations
(559) 324-4844
Primary Contact
Community Medical Center
Joel Weber, Director of Finance -Pharmacy and 340B
(559) 231-1504
Addresses
Street Address
2335 E. Kashian Ln, Suite 301
Fresno, CA 93701
Billing Address
Community Regional Medical Center
P.O. Box 1232
Fresno, CA 93715-1231
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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