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DSH030024 ST JOSEPH'S HOSPITAL AND MEDICAL CENTER (Active)
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Main Details
Name
ST JOSEPH'S HOSPITAL AND MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030024
Medicare Provider Number
030024
Additional Details
Current Program Status
Active
Registration Date
8/23/2007
Participating Start Date
1/1/2005
Participating Approval Date
8/23/2007
Last Recertification Date
8/18/2024
Contacts
Authorizing Official
St.Joseph's Hospital and Medical Center
Jeffrey Jackson, Chief Financial Officer
(602) 406-4618
Primary Contact
CommonSpirit Health - Central Region
Mitchell Schultz, RPh, 340b Regional Manager
(701) 928-0620
Addresses
Street Address
350 W THOMAS ROAD
PHOENIX, AZ 85013
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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3/8/12 update zipcode last digit from 4 to 3 and add new shipping addresses
03/08/2012
May 2025
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