340B Drug Pricing Program Database
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DSH050254A MARSHALL HOSPITAL (Active)
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Main Details
Name
MARSHALL HOSPITAL
Subdivision Name
MMF OP INFUSION
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050254A
Medicare Provider Number
050254
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/26/2015
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Marshall Medical Center
Siri Nelson, CEO
(707) 349-8127
Primary Contact
Marshall Medical Center
Stephanie A Godon, Director of Pharmacy
(530) 626-2703
Addresses
Street Address
3581 PALMER DRIVE suite 400
CAMERON PARK, CA 95682
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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