Covered Entity Details

DSH140015Q BLESSING HOSPITAL (Active) - information as of 4/28/2025 1:47:41 AM

Main Details

Name

BLESSING HOSPITAL

Subdivision Name

BLESSING BARIATRIC INSTITUTE - Bariatric/Weight Loss

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH140015Q

Medicare Provider Number

140015

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/7/2025

Participating Start Date

4/1/2025

Participating Approval Date

1/27/2025

Last Recertification Date

Contacts

Authorizing Official

Blessing Hospital
Pat Gerveler, Executive Vice President/Chief Financial Officer
(217) 223-8400 Ext: 6814

Primary Contact

Blessing Health
Robert Ritchey, Administrative Director BHS Pharmacy & Supply Chain
(217) 223-8400 Ext: 6411

Addresses

Street Address

1107 COLLEGE AVE
QUINCY, IL 62301-2600

Billing Address

Blessing Health
PO Box 7005
Quincy, IL 62305

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
IA	0699108	1760571699
MO	10673101	1760571699
IL	370661183001	1760571699

Shipping Addresses

Shipping Address 1

Blessing Hospital
1005 Broadway
Quincy, IL 62301

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH140015A	Child	DSH	BLESSING HOSPITAL	BLESSING HOSPITAL SLEEP CENTER - Sleep Clinic	1132 BROADWAY ST	QUINCY	IL	Active
DSH140015AA	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Family Med	100 Medical Drive	Hannibal	MO	Active
DSH140015AB	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Internal Med	100 Medical Drive	Hannibal	MO	Active
DSH140015AC	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - OB/GYN	100 Medical Drive	Hannibal	MO	Active
DSH140015AD	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Oncology Infusion Center	100 Medical Dr	Hannibal	MO	Active
DSH140015AE	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Peds	100 Medical Drive	Hannibal	MO	Active
DSH140015AF	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Walk In Clinic	100 Medical Drive	Hannibal	MO	Active
DSH140015AG	Child	DSH	BLESSING HOSPITAL	BLESSING HOSPITAL - BLESSING HEALTH OUTPATIENT SPECIALTISTS - Express Clinic	420 N 34TH ST	QUINCY	IL	Active
DSH140015AH	Child	DSH	BLESSING HOSPITAL	BLESSING HOSPITAL PODIATRY - Podiatry	4800 MAINE ST	QUINCY	IL	Active
DSH140015AJ	Child	DSH	BLESSING HOSPITAL	BLESSING HOSPITAL RHEUMATOLOGY - Rheumatology	4800 MAINE ST	QUINCY	IL	Active
DSH140015AK	Child	DSH	BLESSING HOSPITAL	48th RHC - Family Medicine	4800 Maine	Quincy	IL	Active
DSH140015AL	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Kahoka RHC	400 N Main St	Monroe City	MO	Approved
DSH140015AM	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Hamilton Warsaw RHC	1102 N Co Rd 700	Warsaw	IL	Approved
DSH140015B	Child	DSH	BLESSING HOSPITAL	BLESSING HOSPITAL EAST ADAMS - Rural Health Clinic	102 PRAIRIE MILLS RD	GOLDEN	IL	Active
DSH140015C	Child	DSH	BLESSING HOSPITAL	Mt Sterling RHC - Family Medicine	521 East Main Street	Mt Sterling	IL	Active
DSH140015D	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Podiatry	100 MEDICAL DR	HANNIBAL	MO	Active
DSH140015E	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Neurology	100 MEDICAL DR	HANNIBAL	MO	Active
DSH140015F	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Nephrology	100 MEDICAL DR	Hannibal	MO	Active
DSH140015G	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - General Surgery	100 MEDICAL DR	Hannibal	MO	Active
DSH140015H	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Gastroenterology	100 MEDICAL DR	Hannibal	MO	Active
DSH140015J	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - ENT/Audiology	100 MEDICAL DR	Hannibal	MO	Active
DSH140015K	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Endocrinology	100 MEDICAL DR	Hannibal	MO	Active
DSH140015L	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Cardiology	100 MEDICAL DR	Hannibal	MO	Active
DSH140015M	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Bariatric/Weight Loss	100 MEDICAL DR	Hannibal	MO	Active
DSH140015N	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Allergy	100 MEDICAL DR	Hannibal	MO	Active
DSH140015P	Child	DSH	BLESSING HOSPITAL	BLESSING HOSPITAL - Palmyra Clinic	6996 COUNTY ROAD 326	PALMYRA	MO	Active
DSH140015Q	Child	DSH	BLESSING HOSPITAL	BLESSING BARIATRIC INSTITUTE - Bariatric/Weight Loss	1107 COLLEGE AVE	QUINCY	IL	Active
DSH140015R	Child	DSH	BLESSING HOSPITAL	BLESSING HOSPITAL PAIN MANAGEMENT - Pain	910 BROADWAY ST	QUINCY	IL	Active
DSH140015S	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Hannibal Diagnostic - Ultrasound	100 Medical Drive	Hannibal	MO	Active
DSH140015T	Child	DSH	BLESSING HOSPITAL	BLESSING HOSPITAL NEUROSURGERY - Neurosurgery	4800 MAINE ST	QUINCY	IL	Active
DSH140015U	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Hannibal Diagnostic - Nuclear Medicine/Stress	100 Medical Drive	Hannibal	MO	Active
DSH140015V	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Pulmonary	100 MEDICAL DR	HANNIBAL	MO	Active
DSH140015W	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Rheumatology	100 MEDICAL DR	Hannibal	MO	Active
DSH140015X	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Urology	100 MEDICAL DR	HANNIBAL	MO	Active
DSH140015Y	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Behavioral Health	100 MEDICAL DR	Hannibal	MO	Active
DSH140015Z	Child	DSH	BLESSING HOSPITAL	BLESSING HEALTH OUTPATIENT SPECIALTISTS - Bowling Green Rural Health Clinic	710 Business 61 South	Bowling Green	MO	ToBeTerminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		Approved	Active	4/1/2025 12:01 AM
Contacts	Signed By	Insert	New Registration		Gerveler, Pat Executive Vice President/Chief Financial Officer Blessing Hospital 2172238400-6814	1/27/2025 8:37 AM
Details	340B ID	Update	New Registration		DSH140015Q	1/27/2025 8:37 AM
Details	Entity Subname	Update	New Registration	BLESSING BARIATRIC INSTITUTE	BLESSING BARIATRIC INSTITUTE - Bariatric/Weight Loss	1/27/2025 8:37 AM
Dates	Participating Approval Date	Update	New Registration		1/27/2025 8:37:03 AM	1/27/2025 8:37 AM
Details	State	Update	New Registration	Pending	Approved	1/27/2025 8:37 AM
Dates	Signed By Date	Update	New Registration		1/7/2025 10:31:39 AM	1/27/2025 8:37 AM
Dates	Start Date	Update	New Registration		4/1/2025 12:00:00 AM	1/27/2025 8:37 AM
Addresses	Main Address	Insert	New Registration		1107 COLLEGE AVE QUINCY, IL 62301-2600	1/7/2025 10:12 AM
Addresses	Billing Address	Insert	New Registration		Blessing Health PO Box 7005 Quincy, IL 62305	1/7/2025 10:12 AM
Addresses	Shipping Address	Insert	New Registration		Blessing Hospital 1005 Broadway Quincy, IL 62301	1/7/2025 10:12 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/7/2025 10:12 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		0699108	1/7/2025 10:12 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		IA	1/7/2025 10:12 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/7/2025 10:12 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		10673101	1/7/2025 10:12 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		MO	1/7/2025 10:12 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/7/2025 10:12 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		370661183001	1/7/2025 10:12 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		IL	1/7/2025 10:12 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1760571699	1/7/2025 10:12 AM
Medicaid Billing	NPI: State	Insert	New Registration		IA	1/7/2025 10:12 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1760571699	1/7/2025 10:12 AM
Medicaid Billing	NPI: State	Insert	New Registration		MO	1/7/2025 10:12 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1760571699	1/7/2025 10:12 AM
Medicaid Billing	NPI: State	Insert	New Registration		IL	1/7/2025 10:12 AM
Contacts	Authorizing Official	Insert	New Registration		Gerveler, Pat Executive Vice President/Chief Financial Officer Blessing Hospital 2172238400-6814	1/7/2025 10:12 AM
Contacts	Primary Contact	Insert	New Registration		Ritchey, Robert Administrative Director BHS Pharmacy & Supply Chain Blessing Health 2172238400-6411	1/7/2025 10:12 AM
Details	Assistance Received From Date	Insert	New Registration			1/7/2025 10:12 AM
Details	Assistance Received To Date	Insert	New Registration			1/7/2025 10:12 AM
Details	Last Recertification Date	Insert	New Registration			1/7/2025 10:12 AM
Details	Grant Number	Insert	New Registration			1/7/2025 10:12 AM
Details	340B ID	Insert	New Registration			1/7/2025 10:12 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/7/2025 10:12 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/7/2025 10:12 AM
Details	Medicare Provider Number	Insert	New Registration		140015	1/7/2025 10:12 AM
Details	Entity Name	Insert	New Registration		BLESSING HOSPITAL	1/7/2025 10:12 AM
Details	NOFO Number	Insert	New Registration			1/7/2025 10:12 AM
Details	Program Code	Insert	New Registration		DSH	1/7/2025 10:12 AM
Details	Entity Subname	Insert	New Registration		BLESSING BARIATRIC INSTITUTE	1/7/2025 10:12 AM
Dates	Participating Approval Date	Insert	New Registration			1/7/2025 10:12 AM
Details	State	Insert	New Registration		Pending	1/7/2025 10:12 AM
Dates	Registration Date	Insert	New Registration		1/7/2025 10:12:58 AM	1/7/2025 10:12 AM
Dates	Signed By Date	Insert	New Registration			1/7/2025 10:12 AM
Dates	Start Date	Insert	New Registration			1/7/2025 10:12 AM
Terminations	Termination Comments	Insert	New Registration			1/7/2025 10:12 AM
Terminations	Termination Date	Insert	New Registration			1/7/2025 10:12 AM
Terminations	Termination Effective Date	Insert	New Registration			1/7/2025 10:12 AM
Terminations	Termination Reason	Insert	New Registration			1/7/2025 10:12 AM