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DSH050045E EL CENTRO REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
EL CENTRO REGIONAL MEDICAL CENTER
Subdivision Name
ECRMC Specialty Health Center - Specialty Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050045E
Medicare Provider Number
050045
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
1/24/2020
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
ECRMC
David Momberg, CFO
(858) 208-7724
Primary Contact
EL CENTRO REGIONAL MEDICAL CENTER
Nghiem Ngoc Linh, pharmacist
(760) 339-7180
Addresses
Street Address
1271 Ross Avenue
D
El Centro, CA 92243
Billing Address
El Centro Regional Medical Center
1415 Ross Avenue
El Centro, CA 92243
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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