340B Drug Pricing Program Database


DSH050254F MARSHALL HOSPITAL (Terminated) - information as of 6/23/2025 11:56:58 PM

Main Details
MARSHALL HOSPITAL
MARSHALL WHOLE CHILD HEALTH
Disproportionate Share Hospital
No
DSH050254F
050254


Additional Details
Terminated
1/5/2016
4/1/2016
3/1/2016
9/4/2019

7/1/2020
Business decision by the Covered Entity

Contacts

Marshall Medical Center
Siri Nelson, CEO
(707) 349-8127

Marshall med Ctr
Bob DiPonti, Director of Pharmacy
(530) 626-2657

Addresses

3106 Ponte Morino Drive, Suite B
CAMERON PARK, CA 95682-8277

Marshall Medical Center - Accounts Payable
P.O. Box # 872
Placerville, CA 95667


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
CAHSP40254F 
  1972503142
Shipping Addresses

Marshall Medical Center - Marshall Hospital
1100 Marshall Way
Placerville, CA 95667
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH050254AChildDSHMARSHALL HOSPITALMMF OP INFUSION3581 PALMER DRIVE suite 400CAMERON PARKCAActive
DSH050254AAChildDSHMARSHALL HOSPITALMARSHALL ENT - ENT4300 Golden Center Drive Suite DPlacervilleCAActive
DSH050254ABChildDSHMARSHALL HOSPITALMARSHALL ORTHOPEDICS AND SPORTS MEDICINE EL DORADO HILLS5137 GOLDEN FOOTHILL PARKWAY SUITE 120EL DORADO HILLSCAActive
DSH050254ACChildDSHMARSHALL HOSPITALMARSHALL PULMONOLOGY PLACERVILLE1004 FOWLER WAY SUITE 4PLACERVILLECAActive
DSH050254ADChildDSHMARSHALL HOSPITALMARSHALL PULMONOLOGY - CP3501 Palmer DriveCameron ParkCAActive
DSH050254AEChildDSHMARSHALL HOSPITALMARSHALL CARES - Addiction Treatment Center1045 Marshall WayPlacervilleCATerminated
DSH050254AFChildDSHMARSHALL HOSPITALMARSHALL CANCER CENTER3581 PALMER DRIVE Suite 400Cameron ParkCAActive
DSH050254AGChildDSHMARSHALL HOSPITALMMF NEUROLOGY3581 Palmer DriveCameron ParkCATerminated
DSH050254AHChildDSHMARSHALL HOSPITALDiagnostic Imaging - CT Scanner3581 Palmer DriveCameron ParkCAActive
DSH050254AJChildDSHMARSHALL HOSPITALMMF CARDIOLOGY - EDH5137 Golden Foothill ParkwayEl Dorado HillsCAActive
DSH050254AKChildDSHMARSHALL HOSPITALDiagnostic Imaging - MRI3581 Palmer DriveCameron ParkCAActive
DSH050254ALChildDSHMARSHALL HOSPITALDiagnostic Imaging3581 Palmer DriveCameron ParkCAActive
DSH050254AMChildDSHMARSHALL HOSPITALPhysical Rehab SVCS - Outpatient1000 Fowler WayPlacervilleCAActive
DSH050254ANChildDSHMARSHALL HOSPITALMARSHALL MEDICAL CENTER - RECOVERY - CAMERON PARK SURGERY CENTER3501 PALMER DR 100CAMERON PARKCAActive
DSH050254APChildDSHMARSHALL HOSPITALMARSHALL MEDICAL CENTER - DIAGNOSTIC IMAGING - ULTRASOUND CAMERON PARK3581 PALMER DR 300CAMERON PARKCAActive
DSH050254AQChildDSHMARSHALL HOSPITALMARSHALL MEDICAL CENTER - SURGERY - CAMERON PARK SURGERY CENTER3501 PALMER DR 100CAMERON PARKCAActive
DSH050254BChildDSHMARSHALL HOSPITALCardiac Services - Cardiac Rehab1000 Fowler WayPlacervilleCAActive
DSH050254CChildDSHMARSHALL HOSPITALMARSHALL OUTPATIENT SURGERY3501 PALMER DRIVE, SUITE 100CAMERON PARKCAActive
DSH050254DChildDSHMARSHALL HOSPITALDIVIDE WELLNESS CENTER6065 HIGHWAY 193GEORGETOWNCAActive
DSH050254EChildDSHMARSHALL HOSPITALMARSHALL CARDIOLOGY1004 FOWLER WAY, SUITE 4PlacervilleCAActive
DSH050254FChildDSHMARSHALL HOSPITALMARSHALL WHOLE CHILD HEALTH3106 Ponte Morino Drive, Suite BCAMERON PARKCATerminated
DSH050254GChildDSHMARSHALL HOSPITALMARSHALL EDH / FAMILY MEDICINE5137 GOLDEN FOOTHILL PKWY, #120EL DORADO HILLSCAActive
DSH050254HChildDSHMARSHALL HOSPITALMARSHALL RHEUMATOLOGY3501 PALMER DRIVE, SUITE 201Cameron ParkCAActive
DSH050254JChildDSHMARSHALL HOSPITALMARSHALL SIERRA PRIMARY MEDICINE4341-B GOLDEN CENTER DRIVEPlacervilleCAActive
DSH050254KChildDSHMARSHALL HOSPITALMARSHALL PEDIATRICS4341-A GOLDEN CENTER DRIVEPlacervilleCAActive
DSH050254LChildDSHMARSHALL HOSPITALMARSHALL ORTHOPEDICS4300 GOLDEN CENTER DRIVE, #CPlacervilleCAActive
DSH050254MChildDSHMARSHALL HOSPITALMARSHALL FAMILY MEDICINE CAMERON PARK3581 PALMER DRIVE, SUITE 602Cameron ParkCAActive
DSH050254NChildDSHMARSHALL HOSPITALMARSHALL UROLOGY3501 PALMER DRIVE, SUITE 204Cameron ParkCATerminated
DSH050254PChildDSHMARSHALL HOSPITALMARSHALL OB/GYN CAMERON PARK3501 PALMER DRIVE, SUITE 204Cameron ParkCATerminated
DSH050254QChildDSHMARSHALL HOSPITALMARSHALL WOUND CARE1095 MARSHALL WAY, SUITE 203PlacervilleCAActive
DSH050254RChildDSHMARSHALL HOSPITALMARSHALL GENERAL SURGERY1095 MARSHALL WAY, SUITE 202PlacervilleCAActive
DSH050254SChildDSHMARSHALL HOSPITALMARSHALL OB/GYN PLACERVILLE1095 MARSHALL WAY, SUITE 201PlacervilleCAActive
DSH050254TChildDSHMARSHALL HOSPITALMARSHALL FAMILY MEDICINE PLACERVILLE1095 MARSHALL WAY, SUITE 100PLACERVILLECAActive
DSH050254UChildDSHMARSHALL HOSPITALMARSHALL GASTROENTEROLOGY3501 PALMER DR STE 201CAMERON PARKCAActive
DSH050254VChildDSHMARSHALL HOSPITALMARSHALL CARDIOLOGY CAMERON PARK3501 Palmer DriveCameron ParkCAActive
DSH050254WChildDSHMARSHALL HOSPITALMARSHALL GASTROENTEROLOGY PLACERVILLE - GI PLACERVILLE1095 MARSHALL WAY SUITE 101PLACERVILLECATerminated
DSH050254XChildDSHMARSHALL HOSPITALMARSHALL UROLOGY PLACERVILLE1095 MARSHALL WAY SUITES 201 & 202PLACERVILLECAActive
DSH050254YChildDSHMARSHALL HOSPITALMARSHALL PODIATRY3501 PALMER DRIVE SUITE 201CAMERON PARKCAActive
DSH050254ZChildDSHMARSHALL HOSPITALMARSHALL PSYCHIATRY CAMERON PARK - PSYCH CP3581 PALMER DRIVE SUITE 202CAMERON PARKCATerminated
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsStateUpdate To Be TerminatedTerminated7/1/2020 12:01 AM
DatesLast Date That 340B Drugs PurchasedUpdateTermination Request 2/28/2020 12:00:00 AM5/12/2020 1:29 PM
DetailsStateUpdateTermination RequestActiveTo Be Terminated5/12/2020 1:29 PM
TerminationsTermination CommentsUpdateTermination Request low volume5/12/2020 1:29 PM
TerminationsTermination DateUpdateTermination Request 7/1/2020 12:00:00 AM5/12/2020 1:29 PM
TerminationsTermination Effective DateUpdateTermination Request 5/1/2020 12:00:00 AM5/12/2020 1:29 PM
TerminationsTermination ReasonUpdateTermination Request Business decision by the Covered Entity5/12/2020 1:29 PM
AddressesMain AddressUpdateChange Request 5137 GOLDEN FOOTHILL PKWY, #120 EL DORADO HILLS, CA 95762 3106 Ponte Morino Drive, Suite B CAMERON PARK, CA 95682-82773/18/2020 5:10 PM
DetailsEntity SubnameUpdateChange RequestWHOLE CHILD HEALTH / PediatricsMARSHALL WHOLE CHILD HEALTH3/18/2020 5:10 PM
ContactsAuthorizing OfficialUpdateAO Change RequestWhipple, James Chief Executive Officer Marshall Medical Center 5306262601Nelson, Siri CEO Marshall Medical Center 707349812712/31/2019 7:34 AM
DetailsLast Recertification DateUpdateRecertification8/21/2018 8:04:35 PM9/4/2019 5:27:00 PM9/4/2019 5:27 PM
DetailsLast Recertification DateUpdateRecertification11/16/2017 6:40:57 PM8/21/2018 8:04:35 PM8/21/2018 8:04 PM
DetailsLast Recertification DateUpdateRecertification8/12/2016 12:00:00 AM11/16/2017 6:40:57 PM11/16/2017 6:40 PM
ContactsAuthorizing OfficialUpdate Whipple, James Chief Executive Officer 5306262601Whipple, James Chief Executive Officer Marshall Medical Center 530626260110/17/2017 2:19 PM
ContactsSigned ByUpdate Whipple, James Chief Executive Officer 5306262601Whipple, James Chief Executive Officer Marshall Medical Center 530626260110/17/2017 2:19 PM
ContactsPrimary ContactUpdate DiPonti, Bob Director of Pharmacy 5306262657DiPonti, Bob Director of Pharmacy Marshall med Ctr 53062626579/26/2017 7:53 PM
ContactsAuthorizing OfficialInsert  Whipple, James Chief Executive Officer 53062626018/10/2017 10:39 PM
ContactsSigned ByInsert  Whipple, James Chief Executive Officer 53062626018/10/2017 10:39 PM
ContactsPrimary ContactInsert  DiPonti, Bob Director of Pharmacy 530626265712/12/2016 3:34 PM
AddressesMain AddressInsert   5137 GOLDEN FOOTHILL PKWY, #120 EL DORADO HILLS, CA 9576210/28/2016 6:29 PM
AddressesBilling AddressInsert  Marshall Medical Center - Accounts Payable P.O. Box # 872 placerville, CA 9566710/28/2016 6:29 PM
AddressesShipping AddressInsert  Marshall Medical Center - Marshall Hospital 1100 Marshall way placerville, CA 9566710/28/2016 6:29 PM
DetailsLast Recertification DateUpdate  8/12/2016 12:00:00 AM8/12/2016 7:54 AM
DatesParticipating Approval DateUpdate  3/1/2016 12:00:00 AM3/1/2016 4:56 PM
DetailsStateUpdate PendingActive3/1/2016 4:56 PM
DatesStart DateUpdate  4/1/2016 12:00:00 AM3/1/2016 4:56 PM
Details340B IDUpdate OUTPATIENT_ONLINE_REG_56624DSH050254F2/24/2016 9:37 AM
Details340B IDUpdate  OUTPATIENT_ONLINE_REG_566241/5/2016 4:02 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False1/5/2016 4:02 PM
Medicaid BillingMedicaid: NumberInsert  HSP40254F1/5/2016 4:02 PM
Medicaid BillingMedicaid: StateInsert  CA1/5/2016 4:02 PM
Medicaid BillingNPI: NumberInsert  19725031421/5/2016 4:02 PM
DetailsLast Recertification DateInsert   1/5/2016 4:02 PM
DetailsGrant NumberInsert   1/5/2016 4:02 PM
Details340B IDInsert   1/5/2016 4:02 PM
DetailsIs Authorizing Official EHB DataInsert   1/5/2016 4:02 PM
DatesLast Date That 340B Drugs PurchasedInsert   1/5/2016 4:02 PM
DetailsMedicare Provider NumberInsert  0502541/5/2016 4:02 PM
DetailsEntity NameInsert  MARSHALL HOSPITAL1/5/2016 4:02 PM
DetailsProgram CodeInsert  DSH1/5/2016 4:02 PM
DetailsEntity SubnameInsert  WHOLE CHILD HEALTH / Pediatrics1/5/2016 4:02 PM
DatesParticipating Approval DateInsert   1/5/2016 4:02 PM
DetailsStateInsert  Pending1/5/2016 4:02 PM
DatesRegistration DateInsert  1/5/2016 12:00:00 AM1/5/2016 4:02 PM
DatesSigned By DateInsert  1/5/2016 12:00:00 AM1/5/2016 4:02 PM
DatesStart DateInsert   1/5/2016 4:02 PM
TerminationsTermination CommentsInsert   1/5/2016 4:02 PM
TerminationsTermination DateInsert   1/5/2016 4:02 PM
TerminationsTermination Effective DateInsert   1/5/2016 4:02 PM
TerminationsTermination ReasonInsert   1/5/2016 4:02 PM