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DSH500030 ST. JOSEPH MEDICAL CENTER (Active)
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Main Details
Name
ST. JOSEPH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500030
Medicare Provider Number
500030
Additional Details
Current Program Status
Active
Registration Date
8/22/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/27/2018
Last Recertification Date
8/18/2024
Contacts
Authorizing Official
Peacehealth.org
Krista N Touros, CFO
(360) 788-6754 Ext: 6754
Primary Contact
Peacehealth St Joseph Medical Center
Jeffrey Nicholas Corsentino, Pharmacy Director
(360) 788-6022 Ext: 6022
Addresses
Street Address
2901 SQUALICUM PARKWAY
BELLINGHAM, WA 98225-1851
Billing Address
PeaceHealth Corporate Office
1115 SE 164th, Suite 332
Vancouver, WA 98683
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2010, terminated 7/1/2013. Reinstated 10/1/2018.
08/24/2018
3/27/12 Removed Medicaid #s(3300548, 3308905, 3500048) and NPI #s (1710945910, 1083672273, 1689677320); 11/30/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %-09/23/10-PEACEHEALTH D/B/A ST. JOSEPH MEDICAL CENTER(WAS ST JOSEPH HOSPITAL)05/05/11 ADDED MEDICAID#
03/27/2012
11/30/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %-09/23/10-PEACEHEALTH D/B/A ST. JOSEPH MEDICAL CENTER(WAS ST JOSEPH HOSPITAL)05/05/11 ADDED MEDICAID#
05/09/2011
April 2025
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