340B Drug Pricing Program Database


DSH370037BS SSM HEALTH ST ANTHONY HOSPITAL - OKC (Active) - information as of 6/6/2025 12:37:49 PM

Main Details
SSM HEALTH ST ANTHONY HOSPITAL - OKC
SAPO Healthplex Mustang Pediatrics - Pediatrics
Disproportionate Share Hospital
No
DSH370037BS
370037


Additional Details
Active
4/10/2024
7/1/2024
6/13/2024
8/31/2024

Contacts

- SSM ST ANTHONY HOSPITAL
Shasta Manuel, VP of Finance CFO
(405) 272-7282

SSM Health
Nathan Przybysz, 340b Program Manager
(314) 989-2214

Addresses

201 S Sara Road
Suite 200
Mustang, OK 73064

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
OK100699540A1366545311
Shipping Addresses

Same as Street Address
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH370037AChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCBONE AND JOINT REPLACE CTR OP OBS1111 N DEWEY AVENUEOKLAHOMA CITYOKActive
DSH370037AAChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSSM ST ANTHONY SOUTH DAY TREATMENT CLINIC2129 SW 59TH STREETOKLAHOMA CITYOKActive
DSH370037ABChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt Anthony Physicians Healthplex North13401 N Western AveOklahoma CityOKActive
DSH370037ACChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt Anthony Healthplex North ED13401 N Western AveOklahoma CityOKActive
DSH370037ADChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCST ANTHONY PHYSICIANS RHEUMATOLOGY13401 N WESTERN AVENUEOKLAHOMA CITYOKActive
DSH370037AFChildDSHSSM ST ANTHONY HOSPITALSt Anthony Physicians Endocrinology13401 N WESTERN AVE, STE 407OKLAHOMA CITYOKTerminated
DSH370037AGChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCMidtown Surgery Center1110 N Lee AveOklahoma CityOKActive
DSH370037AHChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt Anthony Physicians Neurology Associates535 NW 9th StOklahoma CityOKActive
DSH370037AJChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt Anthony Physicians Pulmonary Clinic608 NW 9th StOklahoma CityOKActive
DSH370037AKChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCCancer Specialists of Oklahoma3525 NW 56th StOklahoma CityOKActive
DSH370037ALChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCBONE AND JOINT HOSPITAL ANESTHESIA - BONE AND JOINT HOSPITAL ANESTHESIA1111 N DEWEY AVENUEOKLAHOMA CITYOKActive
DSH370037AMChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCEdmond Outpatient Behavioral Health Services416 W 15th St Building 700EdmondOKActive
DSH370037ANChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCBone and Joint Hospital Physical Therapy1111 N Dewey AveOklahoma CityOKActive
DSH370037APChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSSM St. Anthony South Adolescent Treatment Clinic2129 SW 59th StreetOklahoma CityOKActive
DSH370037AQChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCBone and Joint Hospital Radiology1111 N Dewey AveOklahoma CityOKActive
DSH370037ARChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCBone and Joint Surgery1111 N Dewey AveOklahoma CityOKActive
DSH370037ASChildDSHSSM ST ANTHONY HOSPITALBONE AND JOINT PHARMACY - BONE AND JOINT PHARMACY1111 N DEWEYOKLAHOMA CITYOKTerminated
DSH370037ATChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCBone and Joint Acute Care1111 N Dewey AveOklahoma CityOKActive
DSH370037AUChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt Anthony Hospital Healthplex West ED - Emergency Department3333 Territory LnEl RenoOKActive
DSH370037AVChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt Anthony Healthplex East Specialists (Neuro Oncology)3400 S Douglas BlvdOklahoma CityOKActive
DSH370037AWChildDSHSSM ST ANTHONY HOSPITALSAS-Partial Hospital / SAP BHS STAGES - SAS-Partial Hospital / SAP BHS STAGES2129 SW 59th StOKLAHOMA CITYOKTerminated
DSH370037AXChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO MED ONC1000 N Lee AveOKLAHOMA CITYOKToBeTerminated
DSH370037AYChildDSHSSM ST ANTHONY HOSPITALOrtho Sports Med MT / SAPO ORTH SPTS MED MT - Ortho Sports Med MT / SAPO ORTH SPTS MED MT1110 N Lee AvenueOKLAHOMA CITYOKTerminated
DSH370037AZChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCNuclear Med-Heart/Va / SAH HEART & VASC NM - Nuclear Med-Heart/Va / SAH HEART & VASC NM608 NW 9thOKLAHOMA CITYOKActive
DSH370037BChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt Anthony Physicians North6201 N. Santa FeOklahoma CityOKActive
DSH370037BAChildDSHSSM ST ANTHONY HOSPITALBHS Adult / SAH BHS ADULT - BHS Adult / SAH BHS ADULT2129 S.W. 59thOKLAHOMA CITYOKToBeTerminated
DSH370037BBChildDSHSSM ST ANTHONY HOSPITALSAPO ENDO ASSOC-Medical / SAPO ENDO ASSOC - SAPO ENDO ASSOC-Medical / SAPO ENDO ASSOC1111 N. LeeOklahoma CityOKTerminated
DSH370037BCChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCHealthplx Mustang CT / HPM CT / HPM RADIOLOGY - Healthplx Mustang CT / HPM CT / HPM RADIOLOGY201 S Sara RdMUSTANGOKActive
DSH370037BDChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCHealthplex North MRI / HPN MRI - Healthplex North MRI / HPN MRI13401 N Western AveOKLAHOMA CITYOKActive
DSH370037BEChildDSHSSM ST ANTHONY HOSPITALSAPO MWC PAIN / SAPO MWC PAIN - SAPO MWC PAIN / SAPO MWC PAIN1800 S. Douglas BlvdMidwest CityOKTerminated
DSH370037BFChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCHP North IV Therapy / HPN IV THERAPY - HP North IV Therapy / HPN IV THERAPY13401 N Western AveOKLAHOMA CITYOKActive
DSH370037BGChildDSHSSM ST ANTHONY HOSPITALSAPO CARDVASC DISEA / SAPO CARDVASC DISEASE - SAPO CARDVASC DISEA / SAPO CARDVASC DISEASE608 NW 9th StOklahoma CityOKTerminated
DSH370037BHChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO ORTH SPTS MED MUS / SAPO ORTH SPTS MED MUS - SAPO ORTH SPTS MED MUS / SAPO ORTH SPTS MED MUS201 S Sara RdMUSTANGOKActive
DSH370037BJChildDSHSSM ST ANTHONY HOSPITALCancer Care Pet CT / SAPO CSOO PET\CT - Cancer Care Pet CT / SAPO CSOO PET\CT3525 NW 56th StreetOklahoma CityOKTerminated
DSH370037BKChildDSHSSM ST ANTHONY HOSPITALBone and Joint Hospital / Anesthesia - Bone and Joint Hospital / Anesthesia1110 North Lee AvenueOklahoma CityOKTerminated
DSH370037BLChildDSHSSM ST ANTHONY HOSPITALSt. Anthony Physicians' Office / Family Medicine - St. Anthony Physicians' Office / Family Medicine6201 N. Santa Fe, Suite 2020Oklahoma CityOKTerminated
DSH370037BMChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Neurovascular Surgery - Neurovascular Surgery800 NW 9th StOklahoma CityOKActive
DSH370037BNChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Endocrinology - Endocrinology6205 N Santa Fe AveOklahoma CityOKActive
DSH370037BPChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Neurosurgical Oncology - Neurosurgical Oncology800 NW 9th StOklahoma CityOKActive
DSH370037BQChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Gastrology MOB 235 - Gastrology535 NW 9th StOklahoma CityOKActive
DSH370037BRChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Healthplex Mustang Pain Care - Pain201 S Sara RoadMustangOKActive
DSH370037BSChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Healthplex Mustang Pediatrics - Pediatrics201 S Sara RoadMustangOKActive
DSH370037BTChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Cardiology Healthplex Mustang - Cardiology201 S Sara RoadMustangOKActive
DSH370037BUChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Healthplex South Pediatrics - Pediatrics13500 S Tulsa DrOklahoma CityOKActive
DSH370037BVChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Sleep Healthplex North - Sleep Medicine6205 N Santa Fe AveOklahoma CityOKActive
DSH370037BWChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Pulmonary Healthplex North - Pulmonology13401 N Western AveOklahoma CityOKActive
DSH370037BXChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Pain Healthplex North - Pain13401 N Western AveOklahoma CityOKActive
DSH370037BYChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Neurology Healthplex North - Neurology13401 N Western AveOklahoma CityOKActive
DSH370037BZChildDSHSSM ST ANTHONY HOSPITALSAPO Healthplex North Primary Care - Primary Care13401 N Western AveOklahoma CityOKTerminated
DSH370037CAChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSAPO Cardiology Healthplex North - Cardiology13401 N Western AveOklahoma CityOKActive
DSH370037DChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Physicians Choctaw15679 NE 23rd StreetChoctawOKActive
DSH370037EChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Healthplex East Internal Medicine3400 S. Douglas Blvd.Oklahoma CityOKActive
DSH370037FChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Family Medicine Center1110 N. Lee Ave., Suite 300OKLAHOMA CITYOKActive
DSH370037GChildDSHSSM ST ANTHONY HOSPITALSt. Anthony Physicians Heart and Vascular Clinic608 N.W. 9thOklahoma CItyOKTerminated
DSH370037HChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSSM Health Neurology800 NW 9th StOklahoma CityOKActive
DSH370037JChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Hematology Oncology Radiation1011 N. Dewey AveOklahoma CityOKActive
DSH370037KChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Physicians Heart and Vascular Clinic608 N.W. 9th St.Oklahoma CityOKActive
DSH370037LChildDSHSSM ST ANTHONY HOSPITALSt. Anthony Vascular Associates608 N.W. 9th St.Oklahoma CityOKTerminated
DSH370037MChildDSHSSM ST ANTHONY HOSPITALSt. Anthony Pulmonary Specialty Clinic6205 N. Santa FeOklahoma CItyOKTerminated
DSH370037NChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Family Medicine South13500 S. Tulsa DrOklahoma CityOKActive
DSH370037PChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Family Medicine East3400 S. DouglasOKLAHOMA CITYOKActive
DSH370037QChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Hospital Healthplex South ED13500 S. Tulsa DriveOklahoma CityOKActive
DSH370037RChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Healthplex East ED3400 S. DouglasOklahoma CityOKActive
DSH370037SChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Midtown Pediatrics608 N.W. 9thOklahoma CityOKActive
DSh370037TChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Behaviorial Medicine1031 N. Lee AveOklahoma CityOKActive
DSH370037UChildDSHSSM ST ANTHONY HOSPITALSt. Anthony Shawnee Physicians Shawnee Family Medicine3214 Kethley RoadShawneeOKTerminated
DSH370037VChildDSHSSM ST ANTHONY HOSPITALSt. Anthony Shawnee Physicians3315 Kethley RoadShawneeOKTerminated
DSH370037WChildDSHSSM ST ANTHONY HOSPITALSaints Pediatric Associates608 N.W. 9th StreetOKLAHOMA CITYOKTerminated
DSH370037XChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSt. Anthony Healthplex Mustang ED201 S Sara RoadMustangOKActive
DSH370037YChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCSSM HEALTH CARE OF OKLAHOMA, INC./ST ANTHONY PHYSICIANS MUSTANG201 S Sara RoadMustangOKActive
DSH370037ZChildDSHSSM HEALTH ST ANTHONY HOSPITAL - OKCST ANTHONY PHYSICIANS GASTROENTEROLOGY IBD535 NW 9th StOklahoma CityOKActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsEntity NameUpdateChange RequestSSM ST ANTHONY HOSPITALSSM HEALTH ST ANTHONY HOSPITAL - OKC6/5/2025 12:27 PM
ContactsPrimary ContactUpdatePC Change RequestSchmitt, Michelle Nicole VP Pharmacy Financial Operations SSM Health 6082946203Przybysz, Nathan 340b Program Manager SSM Health 31498922145/20/2025 11:07 AM
ContactsPrimary ContactUpdateProfile Change RequestSchmitt, Michelle Nicole Director of Business Operations SSM Health 6082946203Schmitt, Michelle Nicole VP Pharmacy Financial Operations SSM Health 60829462035/19/2025 2:43 PM
DetailsLast Recertification DateUpdateRecertification 8/31/2024 1:41:47 PM8/31/2024 1:41 PM
DetailsStateUpdate ApprovedActive7/1/2024 12:01 AM
ContactsSigned ByInsertNew Registration Manuel, Shasta VP of Finance CFO - SSM ST ANTHONY HOSPITAL 40527272826/13/2024 2:12 PM
Details340B IDUpdateNew Registration DSH370037BS6/13/2024 2:12 PM
DetailsEntity NameUpdateNew RegistrationST ANTHONY HOSPITALSSM ST ANTHONY HOSPITAL6/13/2024 2:12 PM
DetailsEntity SubnameUpdateNew RegistrationSAPO Healthplex Mustang PediatricsSAPO Healthplex Mustang Pediatrics - Pediatrics6/13/2024 2:12 PM
DatesParticipating Approval DateUpdateNew Registration 6/13/2024 2:12:44 PM6/13/2024 2:12 PM
DetailsStateUpdateNew RegistrationPendingApproved6/13/2024 2:12 PM
DatesSigned By DateUpdateNew Registration 6/10/2024 3:37:26 PM6/13/2024 2:12 PM
DatesStart DateUpdateNew Registration 7/1/2024 12:00:00 AM6/13/2024 2:12 PM
ContactsPrimary ContactUpdateProfile Change RequestSchmitt, Michelle Nicole Director of Business Operations SSM Health 6082846203Schmitt, Michelle Nicole Director of Business Operations SSM Health 60829462035/7/2024 9:40 AM
AddressesMain AddressInsertNew Registration  201 S Sara Road Suite 200 Mustang, OK 730644/10/2024 3:41 PM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False4/10/2024 3:41 PM
Medicaid BillingMedicaid: NumberInsertNew Registration 100699540A4/10/2024 3:41 PM
Medicaid BillingMedicaid: StateInsertNew Registration OK4/10/2024 3:41 PM
Medicaid BillingNPI: NumberInsertNew Registration 13665453114/10/2024 3:41 PM
Medicaid BillingNPI: StateInsertNew Registration OK4/10/2024 3:41 PM
ContactsAuthorizing OfficialInsertNew Registration Manuel, Shasta VP of Finance CFO - SSM ST ANTHONY HOSPITAL 40527272824/10/2024 3:41 PM
ContactsPrimary ContactInsertNew Registration Schmitt, Michelle Nicole Director of Business Operations SSM Health 60828462034/10/2024 3:41 PM
DetailsAssistance Received From DateInsertNew Registration  4/10/2024 3:41 PM
DetailsAssistance Received To DateInsertNew Registration  4/10/2024 3:41 PM
DetailsLast Recertification DateInsertNew Registration  4/10/2024 3:41 PM
DetailsGrant NumberInsertNew Registration  4/10/2024 3:41 PM
Details340B IDInsertNew Registration  4/10/2024 3:41 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  4/10/2024 3:41 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  4/10/2024 3:41 PM
DetailsMedicare Provider NumberInsertNew Registration 3700374/10/2024 3:41 PM
DetailsEntity NameInsertNew Registration ST ANTHONY HOSPITAL4/10/2024 3:41 PM
DetailsNOFO NumberInsertNew Registration  4/10/2024 3:41 PM
DetailsProgram CodeInsertNew Registration DSH4/10/2024 3:41 PM
DetailsEntity SubnameInsertNew Registration SAPO Healthplex Mustang Pediatrics4/10/2024 3:41 PM
DatesParticipating Approval DateInsertNew Registration  4/10/2024 3:41 PM
DetailsStateInsertNew Registration Pending4/10/2024 3:41 PM
DatesRegistration DateInsertNew Registration 4/10/2024 3:41:26 PM4/10/2024 3:41 PM
DatesSigned By DateInsertNew Registration  4/10/2024 3:41 PM
DatesStart DateInsertNew Registration  4/10/2024 3:41 PM
TerminationsTermination CommentsInsertNew Registration  4/10/2024 3:41 PM
TerminationsTermination DateInsertNew Registration  4/10/2024 3:41 PM
TerminationsTermination Effective DateInsertNew Registration  4/10/2024 3:41 PM
TerminationsTermination ReasonInsertNew Registration  4/10/2024 3:41 PM