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DSH500030P ST. JOSEPH MEDICAL CENTER (Active)
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Main Details
Name
ST. JOSEPH MEDICAL CENTER
Subdivision Name
PeaceHealth Cardiovascular Imaging Center - Echo
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500030P
Medicare Provider Number
500030
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/5/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/16/2022
Last Recertification Date
8/16/2024
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
2980 Squalicum Parkway, Suite #219
Bellingham, WA 98225
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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