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DSH030013AZ YUMA REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
YUMA REGIONAL MEDICAL CENTER
Subdivision Name
YRMC Plaza Mammography
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030013AZ
Medicare Provider Number
030013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2020
Participating Start Date
10/1/2020
Participating Approval Date
7/21/2020
Last Recertification Date
8/17/2023
Termination Date
Termination Reason
10/1/2024
Other
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
2460 S. Parkview Loop #2
76730-10202002
Yuma, AZ 85364
Billing Address
Yuma Regional Medical Center
2400 South Ave A
Yuma, AZ 85364
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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