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DSH030013AW YUMA REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
YUMA REGIONAL MEDICAL CENTER
Subdivision Name
YRMC Family Medicine West 24th St. Plaza
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030013AW
Medicare Provider Number
030013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/12/2020
Participating Start Date
10/1/2020
Participating Approval Date
7/21/2020
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
1965 W 24th Street, Suite A
78710-10208046
A
YUma, AZ 85364
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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