340B Drug Pricing Program Database
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DSH050069AA ST. JOSEPH HOSPITAL OF ORANGE (Active)
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Main Details
Name
ST. JOSEPH HOSPITAL OF ORANGE
Subdivision Name
Pelvic Health - Caloggero Pelvic Health
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050069AA
Medicare Provider Number
050069
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/3/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/1/2024
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
St. Joseph Hospital, Orange
Eileen Haubl, Chief Financial Officer
(949) 364-1400 Ext: 5408
Primary Contact
St Joseph Hospital
Richard T Sakakura, Clinical Pharmacist 340B Specialist
(714) 771-8021
Addresses
Street Address
363 S Main Street
Suite 420
Orange, CA 92868
Billing Address
Providence St. Joseph Hospital
PO Box 696431
San Antonio, TX 72869
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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