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DSH050108D SUTTER VALLEY HOSPITALS DBA SUTTER MEDICAL CENTER SACRAMENTO (Terminated)
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Main Details
Name
SUTTER VALLEY HOSPITALS DBA SUTTER MEDICAL CENTER SACRAMENTO
Subdivision Name
Fort Sutter Infusion Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050108D
Medicare Provider Number
050108
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/26/2015
Last Recertification Date
8/25/2021
Termination Date
Termination Reason
1/1/2022
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Sutter Health
Timothy J. Noakes, CFO
(916) 887-4500
Primary Contact
Sutter Health
Rachel Dunbar, 340B Analyst
(916) 952-3480
Addresses
Street Address
1020 29th Street Suite 690
Sacramento, CA 95816
Billing Address
Sutter Shared Services
Accounts Payable
P.O. Box 619110
Roseville, CA 95661
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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