340B Drug Pricing Program Database
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DSH500030J ST. JOSEPH MEDICAL CENTER (Terminated)
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Main Details
Name
ST. JOSEPH MEDICAL CENTER
Subdivision Name
PEACEHEALTH - SJMC NUCLEAR MEDICINE-CARDIOLOGY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500030J
Medicare Provider Number
500030
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
8/30/2018
Participating Start Date
10/1/2018
Participating Approval Date
9/4/2018
Last Recertification Date
8/30/2022
Termination Date
Termination Reason
4/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Peacehealth.org
Krista N Touros, CFO
(360) 788-6754 Ext: 6754
Primary Contact
Peacehealth St Joseph Medical Center
Jeffrey Nicholas Corsentino, Pharmacy Director
(360) 788-6022 Ext: 6022
Addresses
Street Address
2979 SQUALICUM PKWY 101
BELLINGHAM, WA 98225-1813
Billing Address
PeaceHealth
1115 SE 164th Ave, Ste 332
Vancouver, WA 98683
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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