340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH050242 DOMINICAN HOSPITAL (Active)
Print
Main Details
Name
DOMINICAN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050242
Medicare Provider Number
050242
Additional Details
Current Program Status
Active
Registration Date
2/28/2007
Participating Start Date
4/1/2007
Participating Approval Date
3/1/2007
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Dominican Hospital
Nanette Mickiewicz, CEO
(831) 462-7512
Primary Contact
Dominican Hospital
Patrick Kehoe, Director of Pharmacy
(831) 462-7752
Addresses
Street Address
1555 SOQUEL DRIVE
SANTA CRUZ, CA 95065
Billing Address
Dignity Health AP
3400 Data Drive
3rd floor
Rancho Cordova, CA 95670
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session