340B Drug Pricing Program Database
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DSH050069X ST. JOSEPH HOSPITAL OF ORANGE (Active)
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Main Details
Name
ST. JOSEPH HOSPITAL OF ORANGE
Subdivision Name
CT Scan SJOP
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050069X
Medicare Provider Number
050069
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/3/2014
Participating Start Date
4/1/2014
Participating Approval Date
1/15/2014
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
St. Joseph Hospital, Orange
Eileen Haubl, Chief Financial Officer
(949) 364-1400 Ext: 5408
Primary Contact
St Joseph Hospital
Richard T Sakakura, Clinical Pharmacist 340B Specialist
(714) 771-8021
Addresses
Street Address
1140 W. La Veta Ave
Orange, CA 92868
Billing Address
Providence St. Joseph Hospital
PO Box 696431
San Antonio, TX 72869
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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