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DSH050082D ST JOHNS REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
ST JOHNS REGIONAL MEDICAL CENTER
Subdivision Name
Dignity Infusion Center Ventura - Dignity Infusion Center Ventura
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050082D
Medicare Provider Number
050082
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/12/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/20/2017
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
St. John's Regional Medical Center
Emma Grossman, VP, CFO
(805) 988-2754
Primary Contact
CommonSpirit Health
Ryan Pearcy, 340B Region Manager
(859) 229-5654
Addresses
Street Address
2900 Loma Vista Road
Suite 200
Ventura, CA 93003
Billing Address
Dignity Health AP
3033 North 3rd Avenue
Phoenix, AZ 85013
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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