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CAN050660-06 USC Norris Cancer Hospital (Active)
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Main Details
Name
USC Norris Cancer Hospital
Subdivision Name
Keck Medicine of USC - Arcadia Clinic - Hematology/Oncology - Hematology, Oncology, Sarcoma, Dermatology, Rheumatology, Hepatobiliary, Otolaryngology
Type
Free Standing Cancer Hospital
Rural
No
340B ID
CAN050660-06
Medicare Provider Number
050660
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2022
Participating Start Date
7/1/2022
Participating Approval Date
4/21/2022
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Keck Medicine of USC
Rod Hanners, Chief Operating Officer
(323) 442-8677
Primary Contact
Keck Medicine of USC
Krist Azizian, Chief Pharmacy Officer
(323) 865-3588
Addresses
Street Address
125 W. Huntington Dr
Suite A200
Arcadia, CA 91007
Billing Address
USC Norris Cancer Hospital
1441 Eastlake Avenue
Los Angeles, CA 90033
Comments
Medicaid Billing
Shipping Addresses
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