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SCH320016-00 GILA REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
GILA REGIONAL MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH320016-00
Medicare Provider Number
320016
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/17/2018
Last Recertification Date
8/19/2021
Termination Date
Termination Reason
7/1/2022
Change of covered entity type (non-hospital)
Contacts
Authorizing Official
Gila Regional Medical Center
Paul H Rogers, CFO
(941) 320-2498
Primary Contact
SCH320016-00
Dana Eric Hessel, Director of Pharmcy
(575) 538-4177
Addresses
Street Address
1313 E 32ND STREET
SILVER CITY, NM 88061
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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