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DSH500108M ST. JOSEPH MEDICAL CENTER (Active)
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Main Details
Name
ST. JOSEPH MEDICAL CENTER
Subdivision Name
Interventional Pain Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500108M
Medicare Provider Number
500108
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/11/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/27/2017
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Virginia Mason Franciscan Health
David Nosacka, SVP and CFO
(253) 680-4005
Primary Contact
CommonSpirit Health
Misty McCandless, 340B Program Coordinator NW Region
(757) 406-4583
Addresses
Street Address
1617 South J Street
Tacoma, WA 98405
Billing Address
St Joseph Medical Center
PO Box 636000
Littleton, CO 80163-6000
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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