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CAN050660-13 USC Norris Cancer Hospital (Active)
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Main Details
Name
USC Norris Cancer Hospital
Subdivision Name
USC KENNETH NORRIS JR CANCER HOSPIT - Radiation Oncology
Type
Free Standing Cancer Hospital
Rural
No
340B ID
CAN050660-13
Medicare Provider Number
050660
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/10/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/20/2023
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
25751 MCBEAN PKWY
STE 110
SANTA CLARITA, CA 91355-3701
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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