Covered Entity Details

DSH390035E St. Luke's Quakertown Hospital (Approved) - information as of 5/6/2025 11:13:47 PM

Main Details

Name

St. Luke's Quakertown Hospital

Subdivision Name

ST. LUKE'S QUAKERTOWN HOSPITAL - Spine and Pain Center

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH390035E

Medicare Provider Number

390035

Outpatient Facility Provider Number

Additional Details

Current Program Status

Approved

Registration Date

4/8/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/10/2025

Last Recertification Date

Contacts

Authorizing Official

St. Luke's Quakertown Hospital
Dennis Pfleiger, President
(215) 538-4561

Primary Contact

St Luke's University Health Network
Steven J Frankenbach, Senior Director, Network Reimbursement
(484) 526-3093

Addresses

Street Address

1534 PARK AVE
QUAKERTOWN, PA 18951-1084

Billing Address

St Luke's Hospital-Upper Bucks Campus-Quakertown Spine and Pain Center
1534 Park Avenue
310
Quakertown, PA 18951

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
PA	107557000001	1669405072,1679976211,1457710576,1477657773

Shipping Addresses

Same as Street Address

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
DSH390035A	Child	DSH	St. Luke's Quakertown Hospital	UPPER PERKIOMEN ST LUKES CARE NOW - Urgent Care	2793 GERYVILLE PIKE	PENNSBURG	PA	Active
DSH390035B	Child	DSH	St. Luke's Quakertown Hospital	ST. LUKE'S QUAKERTOWN HOSPITAL - Quakertown Care Now	157 S WEST END BLVD	QUAKERTOWN	PA	Active
DSH390035C	Child	DSH	St. Luke's Quakertown Hospital	St Luke's Hospital Quakertown Campus - Outpatient Respiratory PFT Lab	1021 Park Avenue	Quakertown	PA	Active
DSH390035D	Child	DSH	St. Luke's Quakertown Hospital	St Luke's Hospital Quakertown Campus - Quakertown Outpatient Infusion	1021 Park Avenue	Quakertown	PA	Terminated
DSH390035E	Child	DSH	St. Luke's Quakertown Hospital	ST. LUKE'S QUAKERTOWN HOSPITAL - Spine and Pain Center	1534 PARK AVE	QUAKERTOWN	PA	Approved

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		Pfleiger, Dennis President St. Luke's Quakertown Hospital 2155384561	4/10/2025 1:58 PM
Details	340B ID	Update	New Registration		DSH390035E	4/10/2025 1:58 PM
Details	Entity Name	Update	New Registration	QUAKERTOWN COMMUNITY HOSPITAL	St. Luke's Quakertown Hospital	4/10/2025 1:58 PM
Details	Entity Subname	Update	New Registration	ST. LUKE'S QUAKERTOWN HOSPITAL	ST. LUKE'S QUAKERTOWN HOSPITAL - Spine and Pain Center	4/10/2025 1:58 PM
Dates	Participating Approval Date	Update	New Registration		4/10/2025 1:58:17 PM	4/10/2025 1:58 PM
Details	State	Update	New Registration	Pending	Approved	4/10/2025 1:58 PM
Dates	Signed By Date	Update	New Registration		4/9/2025 8:06:26 AM	4/10/2025 1:58 PM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/10/2025 1:58 PM
Addresses	Main Address	Insert	New Registration		1534 PARK AVE QUAKERTOWN, PA 18951-1084	4/8/2025 3:29 PM
Addresses	Billing Address	Insert	New Registration		St Luke's Hospital-Upper Bucks Campus-Quakertown Spine and Pain Center 1534 Park Avenue 310 Quakertown, PA 18951	4/8/2025 3:29 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/8/2025 3:29 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		107557000001	4/8/2025 3:29 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		PA	4/8/2025 3:29 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1669405072	4/8/2025 3:29 PM
Medicaid Billing	NPI: State	Insert	New Registration		PA	4/8/2025 3:29 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1679976211	4/8/2025 3:29 PM
Medicaid Billing	NPI: State	Insert	New Registration		PA	4/8/2025 3:29 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1457710576	4/8/2025 3:29 PM
Medicaid Billing	NPI: State	Insert	New Registration		PA	4/8/2025 3:29 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1477657773	4/8/2025 3:29 PM
Medicaid Billing	NPI: State	Insert	New Registration		PA	4/8/2025 3:29 PM
Contacts	Primary Contact	Insert	New Registration		Frankenbach, Steven J Senior Director, Network Reimbursement St Luke's University Health Network 4845263093	4/8/2025 3:29 PM
Contacts	Authorizing Official	Insert	New Registration		Pfleiger, Dennis President St. Luke's Quakertown Hospital 2155384561	4/8/2025 3:29 PM
Details	Assistance Received From Date	Insert	New Registration			4/8/2025 3:29 PM
Details	Assistance Received To Date	Insert	New Registration			4/8/2025 3:29 PM
Details	Last Recertification Date	Insert	New Registration			4/8/2025 3:29 PM
Details	Grant Number	Insert	New Registration			4/8/2025 3:29 PM
Details	340B ID	Insert	New Registration			4/8/2025 3:29 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/8/2025 3:29 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/8/2025 3:29 PM
Details	Medicare Provider Number	Insert	New Registration		390035	4/8/2025 3:29 PM
Details	Entity Name	Insert	New Registration		QUAKERTOWN COMMUNITY HOSPITAL	4/8/2025 3:29 PM
Details	NOFO Number	Insert	New Registration			4/8/2025 3:29 PM
Details	Program Code	Insert	New Registration		DSH	4/8/2025 3:29 PM
Details	Entity Subname	Insert	New Registration		ST. LUKE'S QUAKERTOWN HOSPITAL	4/8/2025 3:29 PM
Dates	Participating Approval Date	Insert	New Registration			4/8/2025 3:29 PM
Details	State	Insert	New Registration		Pending	4/8/2025 3:29 PM
Dates	Registration Date	Insert	New Registration		4/8/2025 3:29:03 PM	4/8/2025 3:29 PM
Dates	Signed By Date	Insert	New Registration			4/8/2025 3:29 PM
Dates	Start Date	Insert	New Registration			4/8/2025 3:29 PM
Terminations	Termination Comments	Insert	New Registration			4/8/2025 3:29 PM
Terminations	Termination Date	Insert	New Registration			4/8/2025 3:29 PM
Terminations	Termination Effective Date	Insert	New Registration			4/8/2025 3:29 PM
Terminations	Termination Reason	Insert	New Registration			4/8/2025 3:29 PM