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DSH050077 SCRIPPS MERCY HOSPITAL (Active)
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Main Details
Name
SCRIPPS MERCY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050077
Medicare Provider Number
050077
Additional Details
Current Program Status
Active
Registration Date
8/30/2006
Participating Start Date
1/1/2005
Participating Approval Date
8/30/2006
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Scripps Mercy Hospital
Tom Gammiere, CEO
(619) 260-7101
Primary Contact
Scripps Mercy Hospital
Lauren Zanecosky, 340B Program Specialist
(619) 260-7308
Addresses
Street Address
4077 FIFTH AVENUE
SAN DIEGO, CA 92103
Billing Address
Scripps Health
Accounts Payable Department, 4S-202
PO Box 2469
La Jolla, CA 92038
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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11/5/09 ADDED BILL TO; 6/1/09 REMOVED MEDICAID# (WAS 05-0077)
08/30/2006
April 2025
April 2025
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