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DSH050107 MARIAN MEDICAL CENTER (Active)
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Main Details
Name
MARIAN MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050107
Medicare Provider Number
050107
Additional Details
Current Program Status
Active
Registration Date
9/4/2007
Participating Start Date
1/1/2005
Participating Approval Date
9/4/2007
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
CommonSpirit Health
Matt Richardson, VP/CFO Service Area CFO
(805) 739-3108
Primary Contact
CommonSpirit Health
Ryan Pearcy, 340B Region Manager
(859) 229-5654
Addresses
Street Address
1400 E CHURCH ST
SANTA MARIA, CA 93454
Billing Address
Dignity Health AP
3033 North 3rd Avenue
Phoenix, AZ 85013
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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