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DSH050047AG SUTTER BAY HOSPITALS DBA CPMC VAN NESS CAMPUS (Active)
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Main Details
Name
SUTTER BAY HOSPITALS DBA CPMC VAN NESS CAMPUS
Subdivision Name
CALIFORNIA PACIFIC MEDICAL CENTER - B.H. CANCER CARE CENTER-BUCHANAN ST
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050047AG
Medicare Provider Number
050047
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/21/2024
Last Recertification Date
Contacts
Authorizing Official
California Pacific Medical Center
HENRY YU, VP AND CFO
(415) 600-3850
Primary Contact
Sutter Health
Rachel L Dunbar, 340B Analyst
(916) 952-3480
Addresses
Street Address
2333 BUCHANAN STREET
San Francisco, CA 94115
Billing Address
Sutter Shared Services Accounts Payable
PO Box 619110
Roseville, CA 95661
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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