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DSH030013AH YUMA REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
YUMA REGIONAL MEDICAL CENTER
Subdivision Name
YRMC SPINE CLINIC 70790 59201001 - 59201001
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030013AH
Medicare Provider Number
030013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/8/2019
Participating Start Date
10/1/2019
Participating Approval Date
9/4/2019
Last Recertification Date
Termination Date
Termination Reason
7/1/2020
Never implemented the 340B Program
Contacts
Authorizing Official
Yuma Regional Medical Center
David Willie, CFO
(928) 336-7015
Primary Contact
Yuma Regional Medical Center
Martin Konopko, 340b Manager
(928) 336-7721
Addresses
Street Address
2851 S Avenue B
2401
Yuma, AZ 85364
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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