340B Drug Pricing Program Database
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DSH050026E GROSSMONT HOSPITAL (Terminated)
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Main Details
Name
GROSSMONT HOSPITAL
Subdivision Name
Sharp Home Infusion - Specialty Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050026E
Medicare Provider Number
050026
Outpatient Facility Provider Number
050026
Additional Details
Current Program Status
Terminated
Registration Date
7/2/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/29/2014
Last Recertification Date
8/17/2015
Termination Date
Termination Reason
7/1/2016
Site closure
Contacts
Authorizing Official
Grossmont Hospital
Daniel Kindron, CFO
(619) 740-4743
Primary Contact
Sharp Healthcare
Besher Flores, 340B Program Specialist
(858) 499-4678
Addresses
Street Address
3558 RUFFIN ROAD SOUTH
SUITE 101
San Diego, CA 92123
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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