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DSH050108B SUTTER MEDICAL CENTER SACRAMENTO (Terminated)
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Main Details
Name
SUTTER MEDICAL CENTER SACRAMENTO
Subdivision Name
Sutter Infusion Pharmacy
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050108B
Medicare Provider Number
050108
Outpatient Facility Provider Number
050108
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/5/2014
Last Recertification Date
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Sutter Health
Timothy J. Noakes, CFO
(916) 887-4500
Primary Contact
Sutter Health
Richard SooHoo, CFO
(916) 733-3811
Addresses
Street Address
2800 L Street Buhler
Bldg #445
Sacramento, CA 95816
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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