340B Drug Pricing Program Database
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DSH100075BD ST JOSEPH'S HOSPITAL (Active)
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Main Details
Name
ST JOSEPH'S HOSPITAL
Subdivision Name
St. Joseph's Hospital Infusion Center - Outpatient Infusion Adult
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100075BD
Medicare Provider Number
100075
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/12/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/25/2023
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Baycare Health System
Carl Tremonti, Chief Financial Officer
(813) 870-4020
Primary Contact
BayCare Health System
Kyle J Brauer, Manager, BayCare Pharmacy Supply Chain
(813) 901-6376
Addresses
Street Address
4510 N Habana Ave
Tampa, FL 33607
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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