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CAH051333-22 Ridgecrest Regional Hospital (Terminated)
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Main Details
Name
Ridgecrest Regional Hospital
Subdivision Name
Ambulatory Surgery Center - Surgery Center
Type
Critical Access Hospital
Rural
No
340B ID
CAH051333-22
Medicare Provider Number
051333
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/20/2023
Last Recertification Date
Termination Date
Termination Reason
7/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Ridgecrest Regional Hospital
Celia Mary Mills, Administrator of Care Coordination and Community Health
(760) 499-3960
Primary Contact
Ridgecrest Regional Hospital760-499-3185
Margie Rose, Program Director
(415) 564-9856
Addresses
Street Address
1111 N China Lake Blvd Ste 220
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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