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RRC030119-00 MERCY GILBERT MEDICAL CENTER (Terminated)
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Main Details
Name
MERCY GILBERT MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
Rural
No
340B ID
RRC030119-00
Medicare Provider Number
030119
Additional Details
Current Program Status
Terminated
Registration Date
1/4/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/11/2018
Last Recertification Date
8/24/2023
Termination Date
Termination Reason
4/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Dignity Health Chandler Regional Medical Center
Eric Sorensen, CFO
(480) 728-3144 Ext: 4807283144
Primary Contact
Mercy Gilbert Medical Center
Chet Messmer, Pharmacist in Charge
(480) 728-3442
Addresses
Street Address
3555 S. VAL VISTA DRIVE
GILBERT, AZ 85297
Billing Address
Dignity Health A/P
3033 N. 3rd Avenue
Phoenix, AZ 85013
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Please correct Government Official email address
01/08/2018
Participating 1/1/2018 until terminated effective 1/1/2018; reinstated effective 4/1/2018
01/05/2018
April 2025
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