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DSH030024D ST JOSEPH'S HOSPITAL AND MEDICAL CENTER (Active)
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Main Details
Name
ST JOSEPH'S HOSPITAL AND MEDICAL CENTER
Subdivision Name
Dignity Health Cancer Institute at St Joseph
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030024D
Medicare Provider Number
030024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/7/2014
Participating Start Date
7/1/2014
Participating Approval Date
6/13/2014
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
St.Joseph's Hospital and Medical Center
Jeffrey Jackson, Chief Financial Officer
(602) 406-4618
Primary Contact
CommonSpirit Health - Central Region
Mitchell Schultz, RPh, 340b Regional Manager
(701) 928-0620
Addresses
Street Address
625 N. 6th Street
PHOENIX, AZ 85004
Billing Address
Dignity Health Accounts Payable
3033 N. 3rd Avenue
Phoenix, AZ 85013
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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