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DSH050348CP UCI MEDICAL CENTER (Active)
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Main Details
Name
UCI MEDICAL CENTER
Subdivision Name
Laguna Hills Infusion
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050348CP
Medicare Provider Number
050348
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/6/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/10/2023
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
UCI Health
Chad Thurman Lefteris, CEO
(714) 714-1423
Primary Contact
UCI Health
Melanie Joe, Chief Pharmacy Officer
(714) 456-5514
Addresses
Street Address
23961 CALLE DE LA MAGDALENA
STE 200
LAGUNA HILLS, CA 92653-3645
Billing Address
UCI Medical Center
Accounts Payable - P O Box C 11917
Santa Ana, CA 92711
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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