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DSH050115N PALOMAR MEDICAL CENTER ESCONDIDO (PMC Escondido) (Active)
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Main Details
Name
PALOMAR MEDICAL CENTER ESCONDIDO (PMC Escondido)
Subdivision Name
PMC Escondido - Crisis Stabilization Unit
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050115N
Medicare Provider Number
050115
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/8/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/9/2020
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
Palomar Health
Diane Lynette Hansen, President & CEO
(760) 740-6395
Primary Contact
Palomar Health
Dondreia Gelios, District Director Pharmacy Services
(442) 281-1358
Addresses
Street Address
2185 Citracado Parkway
Escondido, CA 92029
Billing Address
Palomar Health
120 Craven Road
200
San Marcos, CA 92078
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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