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DSH050047A SUTTER BAY HOSPITALS DBA (Terminated)
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Main Details
Name
SUTTER BAY HOSPITALS DBA
Subdivision Name
CALIFORNIA PACIFIC MEDICAL CENTER CALIFORNIA CAMPUS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050047A
Medicare Provider Number
050047
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
3/3/2009
Participating Start Date
4/1/2009
Participating Approval Date
3/5/2009
Last Recertification Date
8/31/2018
Termination Date
Termination Reason
10/1/2018
Other
Contacts
Authorizing Official
California Pacific Medical Center
HENRY YU, VP AND CFO
(415) 600-3850
Primary Contact
California Pacific Med Ctr
DON WILLIS, PHARMACY PURCH SYSTEMS MANAGER
(415) 600-3200
Addresses
Street Address
3700 CALIFORNIA STREET
SAN FRANCISCO, CA 94118
Billing Address
Same as Street Address
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
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