340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH050129C ST. BERNARDINE MEDICAL CENTER (Terminated)
Print
Main Details
Name
ST. BERNARDINE MEDICAL CENTER
Subdivision Name
CACU
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050129C
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
8/16/2023
Termination Date
Termination Reason
1/1/2024
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
CommonSpirit Health
Anita Chou, Chief Financial Officer
(310) 923-6761
Primary Contact
St. Bernardine Medical Center
Jason M Vest, Director of Pharmacy
(909) 881-4473
Addresses
Street Address
401 Highland Avenue
Second 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
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session