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DSH050557 Sutter Valley Hospitals DBA Memorial Medical Center (Active)
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Main Details
Name
Sutter Valley Hospitals DBA Memorial Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050557
Medicare Provider Number
050557
Additional Details
Current Program Status
Active
Registration Date
9/2/2008
Participating Start Date
9/2/2008
Participating Approval Date
9/2/2008
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Sutter Health
David Scott Wartelle, CFO - Greater Central Valley Market
(209) 572-7009
Primary Contact
Sutter Health
Rachel L Dunbar, 340B Analyst
(916) 952-3480
Addresses
Street Address
1700 COFFEE ROAD
MODESTO, CA 95355
Billing Address
Sutter Shared Services
Accounts Payable
P.O. Box 619110
Roseville, CA 95661
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/23/12 add new ship to address 2/15/12 add new bill to address
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2/15/12 add new bill to address
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