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DSH050077A SCRIPPS MERCY HOSPITAL - CHULA VISTA (Terminated)
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Main Details
Name
SCRIPPS MERCY HOSPITAL - CHULA VISTA
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050077A
Medicare Provider Number
050077
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
8/30/2006
Participating Start Date
1/1/2005
Participating Approval Date
8/30/2006
Last Recertification Date
9/3/2014
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Scripps Mercy Hospital
Tom Gammiere, CEO
(619) 260-7101
Primary Contact
Sherrie Todd, 340b Program Director
(619) 260-7200
Addresses
Street Address
435 H STREET
CHULA VISTA, CA 91910
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Listed as DSH050077C through AJ, and DSH050077BB as of 1/1/15; 6/1/09 REMOVED MEDICAID# (WAS 05-0077)
07/27/2015
6/1/09 REMOVED MEDICAID# (WAS 05-0077)
08/30/2006
April 2025
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