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DSH050150 SIERRA NEVADA MEMORIAL HOSPITAL (Active)
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Main Details
Name
SIERRA NEVADA MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050150
Medicare Provider Number
050150
Additional Details
Current Program Status
Active
Registration Date
4/4/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/14/2016
Last Recertification Date
Contacts
Authorizing Official
Dignity Health
Rob Lowes, CFO
(530) 225-6390
Primary Contact
CommonSpirit Health
Ryan Pearcy, 340B Region Manager
(859) 229-5654
Addresses
Street Address
155 GLASSON WAY
GRASS VALLEY, CA 95945
Billing Address
Dignity Health AP
3033 N. 3rd Avenue
Phoenix, AZ 85013
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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HRSA reinstated as DSH05150 effective 7/1/2016 per the outcome of litigation.
02/05/2025
Participated starting 7/1/2016, terminated 10/1/2024. Reinstated 1/1/2025.
10/16/2024
April 2025
April 2025
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