340B Drug Pricing Program Database
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DSH500108G ST. JOSEPH MEDICAL CENTER (Active)
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Main Details
Name
ST. JOSEPH MEDICAL CENTER
Subdivision Name
St. Joseph Anticoagulation Clinic (Coumadin Clinic)
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500108G
Medicare Provider Number
500108
Outpatient Facility Provider Number
500108
Additional Details
Current Program Status
Active
Registration Date
4/11/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/29/2024
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Virginia Mason Franciscan Health
David Nosacka, SVP and CFO
(253) 680-4005
Primary Contact
CommonSpirit Health
Misty McCandless, 340B Program Coordinator NW Region
(757) 406-4583
Addresses
Street Address
1708 S. Yakima Ave, Suite 20
Tacoma, WA 98405
Billing Address
St. Joseph Medical Center
1717 S J St
Tacoma, WA 98405
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2014, terminated 7/1/2015. Reinstated 7/1/2024.
04/17/2024
June 2025
June 2025
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