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DSH050077P SCRIPPS MERCY HOSPITAL (Terminated)
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Main Details
Name
SCRIPPS MERCY HOSPITAL
Subdivision Name
Chula Vista / ST
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050077P
Medicare Provider Number
050077
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/5/2014
Last Recertification Date
11/30/2017
Termination Date
Termination Reason
10/1/2018
Other
Contacts
Authorizing Official
Scripps Mercy Hospital
Tom Gammiere, CEO
(619) 260-7101
Primary Contact
Scripps Mercy Hospital
Sherrie Todd, Director of Pharmacy Purchasing and 340B Program
(858) 678-7112
Addresses
Street Address
450 Fourth AVe
Ste 212
Chula Vista, CA 91910
Billing Address
Scripps Mercy Hospital - Chula Vista
435 H. St
Chula Vista, CA 91910
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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