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DSH050291A Sutter Bay Hospitals, dba Sutter Santa Rosa Regional Hospital (Active)
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Main Details
Name
Sutter Bay Hospitals, dba Sutter Santa Rosa Regional Hospital
Subdivision Name
SSRRH Outpatient Infusion Center - Infusion
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050291A
Medicare Provider Number
050291
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/2/2019
Participating Start Date
7/1/2019
Participating Approval Date
5/19/2019
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Sutter Health
Henry Yu, Chief Financial Officer, West Bay
(415) 600-3850
Primary Contact
Sutter Health
Daniel E. Camp, 340B Analyst
(619) 977-0058
Addresses
Street Address
3883 Airway Drive
Suite 300
Santa Rosa, CA 95403
Billing Address
Sutter Shared Services
PO Box 619110
Accounts Payable
Roseville, CA 95661
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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