340B Drug Pricing Program Database
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DSH050077AA SCRIPPS MERCY HOSPITAL (Active)
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Main Details
Name
SCRIPPS MERCY HOSPITAL
Subdivision Name
Scripps Mercy Infusion Center/Scripps Prebys Cancer Center, Cancer Treatment Room
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050077AA
Medicare Provider Number
050077
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/5/2014
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Scripps Mercy Hospital
Tom Gammiere, CEO
(619) 260-7101
Primary Contact
Scripps Mercy Hospital
Lauren Zanecosky, 340B Program Specialist
(619) 260-7308
Addresses
Street Address
4044 Fifth Avenue
Second Floor
San Diego, CA 92103
Billing Address
Scripps Health
Accounts Payable Department, CPB333
PO Box 2469
La Jolla, CA 92038
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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