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DSH050360T MARIN GENERAL HOSPITAL (Active)
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Main Details
Name
MARIN GENERAL HOSPITAL
Subdivision Name
MARINHEALTH OUTPATIENT IMAGING CENTER - OUTPATIENT MRI
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050360T
Medicare Provider Number
050360
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2024
Participating Start Date
1/1/2025
Participating Approval Date
11/13/2024
Last Recertification Date
Contacts
Authorizing Official
Marin General Hospital
Elizabeth Lasnier, Controller
(415) 925-7449
Primary Contact
Marin General Hospital
Megan Engler, 340B Coordinator
(415) 328-1454
Addresses
Street Address
2 BON AIR ROAD
120A
LARKSPUR, CA 94939
Billing Address
Marin Health Medical Center
250 Bon Air Road
Greenbrae, CA 94904
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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May 2025
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