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DSH030013AB YUMA REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
YUMA REGIONAL MEDICAL CENTER
Subdivision Name
YRMC Primary Care San Luis
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030013AB
Medicare Provider Number
030013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/12/2019
Participating Start Date
10/1/2019
Participating Approval Date
9/4/2019
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Yuma Regional Medical Center
Vernon Moore, Chief Financial Officer
(928) 336-7015
Primary Contact
Yuma Regional Medical Center
Mark Jordan, Directory of Pharmacy
(928) 336-7815
Addresses
Street Address
845 E B St.
70820-10208028
San Luis, AZ 85349
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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