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DSH050100B SHARP MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
SHARP MEMORIAL HOSPITAL
Subdivision Name
Sharp Mary Birch Hospital for Women and Newborns
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050100B
Medicare Provider Number
050100
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/20/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/27/2012
Last Recertification Date
8/18/2015
Termination Date
Termination Reason
7/1/2016
Site closure
Contacts
Authorizing Official
Sharp Memorial Hospital
TIM SMITH, CEO
(858) 939-4082
Primary Contact
Sharp Healthcare
Besher Flores, 340B Program Specialist
(858) 499-4678
Addresses
Street Address
3003 Health Center Drive
San Diego, CA 92123
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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