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DSH100075BH ST JOSEPH'S HOSPITAL (Approved)
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Main Details
Name
ST JOSEPH'S HOSPITAL
Subdivision Name
ST JOSEPH'S HOSPITAL INFUSION CTR - Outpatient Infusion Clearwater
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100075BH
Medicare Provider Number
100075
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/2/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/8/2025
Last Recertification Date
Contacts
Authorizing Official
Baycare Health System
Carl Tremonti, Chief Financial Officer
(813) 870-4020
Primary Contact
BayCare Health System
Kyle J Brauer, Manager, BayCare Pharmacy Supply Chain
(813) 901-6376
Addresses
Street Address
400 PINELLAS ST
STE 240
CLEARWATER, FL 33756-3318
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
May 2025
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