340B Drug Pricing Program Database
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DSH050127 WOODLAND MEMORIAL HOSPITAL (Active)
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Main Details
Name
WOODLAND MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050127
Medicare Provider Number
050127
Additional Details
Current Program Status
Active
Registration Date
9/13/2006
Participating Start Date
1/1/2005
Participating Approval Date
9/13/2006
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Woodland Memorial Hospital
Gena Bravo, CEO
(530) 669-5355
Primary Contact
CommonSpirit Health
Ryan Pearcy, 340B Region Manager
(859) 229-5654
Addresses
Street Address
1325 COTTONWOOD ST
WOODLAND, CA 95695
Billing Address
Dignity Health Accounts Payable
3033 N 3rd Avenue
Phoenix, AZ 85013
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/26/15 Site self terminated in error, verified eligibility and reinstated same day with no loss of eligibilty for 340B program. JH
08/26/2015
5/07 - DSH ADJ% > 11.75
09/13/2006
April 2025
April 2025
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