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CAH051333-16 Ridgecrest Regional Hospital (Active)
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Main Details
Name
Ridgecrest Regional Hospital
Subdivision Name
RHC V - SSMC Primary Clinic
Type
Critical Access Hospital
Rural
No
340B ID
CAH051333-16
Medicare Provider Number
051333
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2021
Participating Start Date
10/21/2021
Participating Approval Date
10/18/2021
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Ridgecrest Regional Hospital
James Suver, CEO
(760) 499-3902
Primary Contact
Ridgecrest Regional Hospital760-499-3185
Margie Rose, Program Director
(415) 564-9856
Addresses
Street Address
105 E Syndor Ave., Suite 100
Ridgecrest, CA 93555
Billing Address
Ridgecrest Regional Hospital
1081 N China Lake Blvd
Ridgecrest, CA 93555
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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