340B Drug Pricing Program Database
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DSH050077BD SCRIPPS MERCY HOSPITAL (Active)
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Main Details
Name
SCRIPPS MERCY HOSPITAL
Subdivision Name
Breast Care Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050077BD
Medicare Provider Number
050077
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/26/2016
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
550 Washington Street
Suite 200
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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