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DSH500108A ST. JOSEPH MEDICAL CENTER (Active)
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Main Details
Name
ST. JOSEPH MEDICAL CENTER
Subdivision Name
Gig Harbor Same Day Surgery
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500108A
Medicare Provider Number
500108
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
2/14/2012
Participating Start Date
4/1/2012
Participating Approval Date
3/28/2012
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Virginia Mason Franciscan Health
David Nosacka, SVP and CFO
(253) 680-4005
Primary Contact
CommonSpirit Health
Misty McCandless, 340B Program Coordinator NW Region
(757) 406-4583
Addresses
Street Address
6401 Kimball Drive, Suite 100
Gig Harbor, WA 98335
Billing Address
St Joseph Medical Center
PO Box 636000
Littleton, CO 80163-6000
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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