340B Drug Pricing Program Database
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DSH050129E ST. BERNARDINE MEDICAL CENTER (Terminated)
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Main Details
Name
ST. BERNARDINE MEDICAL CENTER
Subdivision Name
Op Surgery
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050129E
Medicare Provider Number
050129
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/4/2016
Last Recertification Date
8/21/2019
Termination Date
Termination Reason
7/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
St Bernardines
Paul Steinke, CFO
(909) 881-7196
Primary Contact
St. Bernardine Medical Center
Jason M Vest, Director of Pharmacy
(909) 881-4473
Addresses
Street Address
401 Highland Avenue
2nd Floor
San Bernardino, CA 92404
Billing Address
Dignity Health Accounts Payable
3033 N. 3rd Ave
Phoenix, AZ 85013
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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