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DSH050047R SUTTER BAY HOSPITALS DBA (Terminated)
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Main Details
Name
SUTTER BAY HOSPITALS DBA
Subdivision Name
CALIFORNIA CAMPUS / RESPIRATORY THERAPY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050047R
Medicare Provider Number
050047
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/21/2017
Last Recertification Date
8/31/2018
Termination Date
Termination Reason
10/1/2019
Site closure
Contacts
Authorizing Official
California Pacific Medical Center
HENRY YU, VP AND CFO
(415) 600-3850
Primary Contact
California Pacific Med Ctr
DON WILLIS, PHARMACY PURCH SYSTEMS MANAGER
(415) 600-3200
Addresses
Street Address
3700 CALIFORNIA ST 3FL 375-376
SAN FRANCISCO, CA 94118
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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