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DSH050047 SUTTER BAY HOSPITALS DBA CPMC VAN NESS CAMPUS (Active)
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Main Details
Name
SUTTER BAY HOSPITALS DBA CPMC VAN NESS CAMPUS
Subdivision Name
CALIFORNIA PACIFIC MEDICAL CENTER PACIFIC CAMPUS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050047
Medicare Provider Number
050047
Additional Details
Current Program Status
Active
Registration Date
3/3/2009
Participating Start Date
4/1/2009
Participating Approval Date
3/5/2009
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
California Pacific Medical Center
HENRY YU, VP AND CFO
(415) 600-3850
Primary Contact
Sutter Health
Rachel L Dunbar, 340B Analyst
(916) 952-3480
Addresses
Street Address
1101 VAN NESS AVE
SAN FRANCISCO, CA 94109
Billing Address
Sutter Shared Services Accounts Payable
PO Box 619110
Roseville, CA 95661
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/26/2010- DOC. RECD. TO CONFIRM ELIG. DSH ADJ%; 2/27/09 DOC RECEIVED TO CONFIRM ELIG DSH ADJ%
05/25/2012
2/26/2010- DOC. RECD. TO CONFIRM ELIG. DSH ADJ%; 2/27/09 DOC RECEIVED TO CONFIRM ELIG DSH ADJ%
03/05/2009
2/26/2010- DOC. RECD. TO CONFIRM ELIG. DSH ADJ%; 2/27/09 DOC RECEIVED TO CONFIRM ELIG DSH ADJ%
03/05/2009
May 2025
May 2025
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