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SHARP REES STEALY PHARMACY #2
DSH050100 SHARP MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
SHARP MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050100
Entity Address
7901 FROST STREET
SAN DIEGO, CA 92123
Medicare Provider Number
050100
Participating Start Date
7/1/2004
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
SHARP REES STEALY PHARMACY #2
Pharmacy Address
525 THIRD AVE
SUITE A
CHULA VISTA, CA 91910-5696
Pharmacy Comments
Contract Details
Approval Date
10/31/2012
Contract Begin Date
10/31/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/31/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kevin Thompson, Chief Financial Officer
(858) 939-3884
Contract Pharmacy Representative
Sharp Rees-Stealy
Josh Schmidt, Chief Financial Officer
(858) 616-8009
Signed By Date
9/28/2012
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