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DSH050082A ST JOHNS REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
ST JOHNS REGIONAL MEDICAL CENTER
Subdivision Name
Outpatient Surgery Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050082A
Medicare Provider Number
050082
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/10/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/8/2014
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
St. John's Regional Medical Center
Emma Grossman, VP, CFO
(805) 988-2754
Primary Contact
CommonSpirit Health
Ryan Pearcy, 340B Region Manager
(859) 229-5654
Addresses
Street Address
1700 N. Rose Ave
Suite 100
Oxnard, CA 93030
Billing Address
Dignity Health AP
3033 North 3rd Avenue
Phoenix, AZ 85013
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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