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DSH050026D GROSSMONT HOSPITAL (Active)
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Main Details
Name
GROSSMONT HOSPITAL
Subdivision Name
Grossmont Medical Terrace - O/P Infusion Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050026D
Medicare Provider Number
050026
Outpatient Facility Provider Number
050026
Additional Details
Current Program Status
Active
Registration Date
7/2/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/29/2014
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Grossmont Hospital
Daniel Kindron, CFO
(619) 740-4743
Primary Contact
Sharp HealthCare
Zephyr T Skeets, 340B Specialist
(858) 499-2148
Addresses
Street Address
8860 Center Drive
Suite 200 & 250
La Mesa, CA 91942
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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