340B Drug Pricing Program Database


DSH260032 BARNES-JEWISH HOSPITAL (Active) - information as of 5/15/2025 2:02:28 AM

Main Details
BARNES-JEWISH HOSPITAL
Disproportionate Share Hospital
No
DSH260032
260032


Additional Details
Active
4/23/2008
7/1/2004
4/23/2008
8/27/2024

Contacts

Barnes-Jewish Hospital
Paul John Irovic, Vice-president, Finance
(314) 265-8874

Barnes Jewish Hospital
Kristin Helton, Pharmacy Manager
(314) 249-7683

Addresses

One Barnes-Jewish Hospital Plaza
St. Louis, MO 63110

Barnes Jewish Hospital
4249 Clayton Ave Ste 310
St. Louis, MO 63110


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
7/15/04 MODIF ADDR (WAS 1 BARNES-JEWISH HOSPITAL DRIVE); 8/29/05 ADD MED #07/31/2009
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
MO010724201,600724223,600117238,600004560,600085031,606351708,606496404,6000351831649299827,1871609784,1750025565,1972354793,1104677921,1245081058,1124879945,1770334591,1659187656
IL237309937001,237309937002,237309937006,237309937004,237309937009,237309937008,237309937007,2373099370101649299827,1871609784,1750025565,1104677921,1245081058,1770334591,1972354793,1659187656,1124879945
Shipping Addresses

Barnes-Jewish Hospital
425 South Euclid Avenue
2nd Floor Institute of Health (Pharmacy)
2105
Saint Louis, MO 63110

Family Care Pharmacy at Barnes Jewish Hospital
1 Barnes Jewish Hospital Plaza
St. Louis, MO 63110

Barnes Jewish Hospital Advanced Family Care Pharmacy
1234 S Kingshighway Blvd Suite 1900
St. Louis, MO 63110

Barnes Jewish Hospital
4533 Clayton Avenue
St. Louis, MO 63110

Barnes Jewish Hospital dba Family Care Oncology Pharmacy
4500 Forest Park Ave
St. Louis, MO 63108

Barnes Jewish Hospital dba Barnes-Jewish Hospital Pharmacy South County
5225 MidAmerica Plaza
St. Louis, MO 63129

Barnes Jewish Hospital dba Barnes-Jewish Hospital Pharmacy St. Peters
150 Entrance Way
St. Peters, MO 63376

Barnes Jewish Hospital dba Barnes-Jewish Hospital Pharmacy West County
10 Barnes West Drive MOB2, Suite 100
St. Louis, MO 63141

Barnes Jewish Hospital dba Barnes-Jewish Hospital Pharmacy North County
1255 Graham Road
Florissant, MO 63031

Barnes Jewish Hospital Pharmacy ACB
1 Barnes Jewish Hospital Plaza
St. Louis, MO 63110
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884904/21/201507/01/2015  07/24/2017
Contract DetailACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750204/21/201507/01/2015 02/10/202502/14/2025
Contract DetailACCREDO HEALTH GROUP INC201 GREAT CIRCLE ROAD
NASHVILLETN3722804/21/201507/01/2015 08/22/201803/10/2020
Contract DetailACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624104/21/201507/01/2015 07/06/202307/10/2023
Contract DetailACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282204/21/201507/01/2015 02/10/202502/14/2025
Contract DetailACCREDO HEALTH GROUP, INC.  PHARMACY
2 BOULDEN CIRCLE SUITE 1 		NEW CASTLEDE1972004/21/201507/01/2015 07/08/201507/24/2017
Contract DetailACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349207/09/201510/01/2015 02/10/202502/14/2025
Contract DetailAVELLA OF DEER VALLEY23620 N 20TH DR #12
PHOENIXAZ85085-062101/20/201504/01/2015 09/22/202010/02/2020
Contract DetailAVELLA OF ST LOUIS450 N NEW BALLAS RD STE 256
SAINT LOUISMO63141-683601/20/201504/01/2015 09/22/202010/02/2020
Contract DetailBEVERLY HILLS PHARMACYCHRISTOPHER GERONSIN INC 7150 NATURAL BRIDGE RD
SAINT LOUISMO63121-515101/20/201504/01/2015 04/19/201904/22/2019
Contract DetailBJC HOME CARE SVC PHARMACYHOME INFUSION 710 S BOYLE AVE
SAINT LOUISMO6311007/16/201810/01/2018 04/19/201904/22/2019
Contract DetailBJC HOME CARE SVC PHARMACYHOME INFUSION 710 S BOYLE AVE
SAINT LOUISMO6311010/15/201901/01/2020  01/01/2020
Contract DetailGATEWAY APOTHECARY, INC.4473 FOREST PARK AVE
SAINT LOUISMO63108-221101/20/201504/01/2015 04/19/201904/22/2019
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02713 753 W HWY 50
O'FALLONIL6226907/17/201510/01/2015 06/15/201707/24/2017
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06830 4609 W. MAIN ST.
BELLEVILLEIL6222607/17/201510/01/2015 06/15/201707/24/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02341 14400 CLAYTON RD.
BALLWINMO6301107/17/201510/01/2015 06/15/201707/24/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 03087 11560 OLIVE BLVD.
CREVE COEURMO6314107/17/201510/01/2015 06/15/201707/24/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05669 7320 GRAVOIS AVE.
ST LOUISMO6311607/17/201510/01/2015 06/15/201707/24/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05670 9141 OLIVE BLVD.
OLIVETTEMO6313207/17/201510/01/2015 06/15/201707/24/2017
Contract DetailMO BAPTIST MEDICAL CENTERFAMILY CARE CENTRAL PHARMACY 1234 S KINGSHIGHWAY BLVD STE 1500
SAINT LOUISMO6311007/16/201810/01/2018 04/19/201904/22/2019
Contract DetailMO BAPTIST MEDICAL CENTERFAMILY CARE CENTRAL PHARMACY 1234 S KINGSHIGHWAY BLVD STE 1500
SAINT LOUISMO6311007/08/202010/01/2020 02/29/202402/29/2024
Contract DetailSCHNUCK MARKETSSCHNUCKS PHARMACY 5055 ARSENAL
SAINT LOUISMO6313901/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCK MARKETSDBA: SCHNUCKS PHARMACY #188. 8867 LADUE ROAD
SAINT LOUISMO6312401/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCK MARKETSD.B.A. SCHNUCKS PHARMACY #192 1020 LOUGHBOROUGH AVE
SAINT LOUISMO63111-262101/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCK MARKETSSCHNUCKS PHARMACY #209 12332 MANCHESTER ROAD
SAINT LOUISMO6313101/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCK MARKETSD.B.A. SCHNUCKS PHARMACY#216 1589 SIERRA VISTA S.C.
SAINT LOUISMO6313801/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCK MARKETSD.B.A. SCHNUCKS PHARMACY #227 4171 LINDELL BLVD
SAINT LOUISMO6310801/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCK MARKETSD.B.A. SCHNUCKS PHARMACY #266 9540 WATSON RD
SAINT LOUISMO6312601/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCK PHARMACYSCHNUCKS MARKETS INC 6600 CLAYTON ROAD
SAINT LOUISMO6311701/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCK'S PHARMACY #1458037 W FLORISSANT AVE
SAINT LOUISMO6313601/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCKS PHARMACYSCHNUCKS MARKETS INC 3431 UNION
SAINT LOUISMO6311501/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCKS PHARMACYSCHNUCK MARKETS INC 6920 OLIVE BLVD
SAINT LOUISMO6313001/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCKS PHARMACYSCHNUCK MARKETS INC 141 HILLTOWN VILLAGE CENTER
CHESTERFIELDMO6301701/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCKS PHARMACYSCHNUCK MARKETS INC 8650 BIG BEND BOULEVARD
#136 		SAINT LOUISMO6311901/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCKS PHARMACYSCHNUCK MARKETS INC 1060 SCHNUCKS WOODS MILL PLAZA
CHESTERFIELDMO6301701/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCKS PHARMACY #141SCHNUCK MARKETS INC 9074 OVERLAND PLAZA
SAINT LOUISMO6311401/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCKS PHARMACY #143SCHNUCK MARKETS INC 3430 SOUTH GRAND BLVD
SAINT LOUISMO6311801/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCKS PHARMACY #196SCHNUCK MARKET INC. 245 EAST 5TH STREET
EUREKAMO6302501/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCKS PHARMACY #198SCHNUCK MARKETS INC 13987 NEW HALLS FERRY RD
FLORISSANTMO6303301/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCKS PHARMACY #258SCHNUCKS MARKETS INC HAMPTON & CHIPPEWA
60 HAMPTON VILLAGE 		SAINT LOUISMO6310901/20/201504/01/2015 10/30/201811/02/2018
Contract DetailSCHNUCKS PHARMACY #301SCHNUCKS MARKETS INC 315 N. 9TH STREET
SAINT LOUISMO63101-140301/20/201504/01/2015 10/30/201811/02/2018
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH260032AChildDSHBARNES-JEWISH HOSPITALBarnes-Jewish Hospital Orthopedic Center14532 South Outer Forty DriveChesterfieldMOActive
DSH260032BChildDSHBARNES-JEWISH HOSPITALBarnes-Jewish Hospital Surgical and Wound Care Center4901 Forest Park AvenueST. LOUISMOActive
DSH260032CChildDSHBARNES-JEWISH HOSPITALPrimary Care Medicine Clinic4901 Forest Park AvenueSt. LouisMOActive
DSH260032DChildDSHBARNES-JEWISH HOSPITALOB/GYN Clinic4901 Forest Park AvenueSt. LouisMOActive
DSH260032EChildDSHBARNES-JEWISH HOSPITALSpecialty Care Clinic4901 Forest Park AvenueSt. LouisMOActive
DSH260032FChildDSHBARNES-JEWISH HOSPITALPsychiatry Clinic4901 Forest Park AvenueSt. LouisMOActive
DSH260032GChildDSHBARNES-JEWISH HOSPITALOB/GYN In Vitro4444 Forest Park AvenueSaint LouisMOActive
DSH260032HChildDSHBARNES-JEWISH HOSPITALCENTER FOR ADVANCED MEDICINE SOUTH / Endoscopy-GI-CSC5201 MID AMERICA PLZSAINT LOUISMOActive
DSH260032JChildDSHBARNES-JEWISH HOSPITALCENTER FOR ADVANCED MEDICINE SOUTH / Rad Interventional - CSC5201 MID AMERICA PLZSAINT LOUISMOActive
DSH260032KChildDSHBARNES-JEWISH HOSPITALCENTER FOR ADVANCED MEDICINE SOUTH / Diagnostic Radiology - CSC 5201 MID AMERICA PLZSAINT LOUISMOActive
DSH260032LChildDSHBARNES-JEWISH HOSPITALCENTER FOR ADVANCED MEDICINE SOUTH / Post Anesth Care Unit- CSC5201 MID AMERICA PLZSAINT LOUISMOActive
DSH260032MChildDSHBARNES-JEWISH HOSPITALCENTER FOR ADVANCED MEDICINE SOUTH / Surgery - CSC5201 MID AMERICA PLZSAINT LOUISMOActive
DSH260032NChildDSHBARNES-JEWISH HOSPITALOUTPATIENT SURGERY CENTER / Ortho Center - Pain Management 214532 S OUTER 40 RDCHESTERFIELDMOActive
DSH260032PChildDSHBARNES-JEWISH HOSPITALOUTPATIENT SURGERY CENTER / Ortho Center - Recovery Room14532 S OUTER 40 RDCHESTERFIELDMOActive
DSH260032QChildDSHBARNES-JEWISH HOSPITALOrtho Center - Surgery-Ambulatory Ctr14532 S OUTER 40 RDCHESTERFIELDMOActive
DSH260032RChildDSHBARNES-JEWISH HOSPITALSITEMAN CANCER CENTER SOUTH COUNTY - Siteman CC So - Radiation Oncology 25225 MID AMERICA PLZSAINT LOUISMOActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesShipping AddressInsertChange Request Barnes Jewish Hospital Pharmacy ACB 1 Barnes Jewish Hospital Plaza St. Louis, MO 631104/22/2025 11:06 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/22/2025 11:03 AM
Medicaid BillingMedicaid: NumberInsertChange Request 2373099370101/22/2025 11:03 AM
Medicaid BillingMedicaid: StateInsertChange Request IL1/22/2025 11:03 AM
Medicaid BillingNPI: NumberInsertChange Request 11248799451/22/2025 11:03 AM
Medicaid BillingNPI: StateInsertChange Request IL1/22/2025 11:03 AM
Medicaid BillingNPI: NumberInsertChange Request 16591876561/17/2025 3:09 PM
Medicaid BillingNPI: StateInsertChange Request MO1/17/2025 3:09 PM
Medicaid BillingNPI: NumberInsertChange Request 16591876561/17/2025 3:09 PM
Medicaid BillingNPI: StateInsertChange Request IL1/17/2025 3:09 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False12/5/2024 3:12 PM
Medicaid BillingMedicaid: NumberInsertChange Request 23730993700412/5/2024 3:12 PM
Medicaid BillingMedicaid: StateInsertChange Request IL12/5/2024 3:12 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False12/5/2024 3:12 PM
Medicaid BillingMedicaid: NumberInsertChange Request 23730993700912/5/2024 3:12 PM
Medicaid BillingMedicaid: StateInsertChange Request IL12/5/2024 3:12 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False12/5/2024 3:12 PM
Medicaid BillingMedicaid: NumberInsertChange Request 23730993700812/5/2024 3:12 PM
Medicaid BillingMedicaid: StateInsertChange Request IL12/5/2024 3:12 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False12/5/2024 3:12 PM
Medicaid BillingMedicaid: NumberInsertChange Request 23730993700712/5/2024 3:12 PM
Medicaid BillingMedicaid: StateInsertChange Request IL12/5/2024 3:12 PM
Medicaid BillingNPI: NumberInsertChange Request 110467792112/5/2024 3:12 PM
Medicaid BillingNPI: StateInsertChange Request IL12/5/2024 3:12 PM
Medicaid BillingNPI: NumberInsertChange Request 124508105812/5/2024 3:12 PM
Medicaid BillingNPI: StateInsertChange Request IL12/5/2024 3:12 PM
Medicaid BillingNPI: NumberInsertChange Request 177033459112/5/2024 3:12 PM
Medicaid BillingNPI: StateInsertChange Request IL12/5/2024 3:12 PM
Medicaid BillingNPI: NumberInsertChange Request 197235479312/5/2024 3:12 PM
Medicaid BillingNPI: StateInsertChange Request IL12/5/2024 3:12 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False11/13/2024 6:02 PM
Medicaid BillingMedicaid: NumberInsertChange Request 60000456011/13/2024 6:02 PM
Medicaid BillingMedicaid: StateInsertChange Request MO11/13/2024 6:02 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False11/13/2024 6:02 PM
Medicaid BillingMedicaid: NumberInsertChange Request 60008503111/13/2024 6:02 PM
Medicaid BillingMedicaid: StateInsertChange Request MO11/13/2024 6:02 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False11/13/2024 6:02 PM
Medicaid BillingMedicaid: NumberInsertChange Request 60635170811/13/2024 6:02 PM
Medicaid BillingMedicaid: StateInsertChange Request MO11/13/2024 6:02 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False11/13/2024 6:02 PM
Medicaid BillingMedicaid: NumberInsertChange Request 60649640411/13/2024 6:02 PM
Medicaid BillingMedicaid: StateInsertChange Request MO11/13/2024 6:02 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False11/13/2024 6:02 PM
Medicaid BillingMedicaid: NumberInsertChange Request 60003518311/13/2024 6:02 PM
Medicaid BillingMedicaid: StateInsertChange Request MO11/13/2024 6:02 PM
Medicaid BillingNPI: NumberInsertChange Request 197235479311/13/2024 6:02 PM
Medicaid BillingNPI: StateInsertChange Request MO11/13/2024 6:02 PM
Medicaid BillingNPI: NumberInsertChange Request 110467792111/13/2024 6:02 PM
Medicaid BillingNPI: StateInsertChange Request MO11/13/2024 6:02 PM
Medicaid BillingNPI: NumberInsertChange Request 124508105811/13/2024 6:02 PM
Medicaid BillingNPI: StateInsertChange Request MO11/13/2024 6:02 PM
Medicaid BillingNPI: NumberInsertChange Request 112487994511/13/2024 6:02 PM
Medicaid BillingNPI: StateInsertChange Request MO11/13/2024 6:02 PM
Medicaid BillingNPI: NumberInsertChange Request 177033459111/13/2024 6:02 PM
Medicaid BillingNPI: StateInsertChange Request MO11/13/2024 6:02 PM
AddressesShipping AddressUpdateChange RequestBarnes Jewish Hospital dba Family Care Oncology Pharmacy 4921 Parkview Pl, 7th floor St. Louis, MO 63110Barnes Jewish Hospital dba Family Care Oncology Pharmacy 4500 Forest Park Ave St. Louis, MO 6310810/3/2024 2:43 PM
DetailsLast Recertification DateUpdateRecertification9/5/2023 11:03:11 AM8/27/2024 3:55:04 PM8/27/2024 3:55 PM
AddressesShipping AddressInsertChange Request Barnes Jewish Hospital dba Family Care Oncology Pharmacy 4921 Parkview Pl, 7th floor St. Louis, MO 631107/2/2024 2:12 PM
AddressesShipping AddressInsertChange Request Barnes Jewish Hospital dba Barnes-Jewish Hospital Pharmacy South County 5225 MidAmerica Plaza St. Louis, MO 631297/2/2024 2:12 PM
AddressesShipping AddressInsertChange Request Barnes Jewish Hospital dba Barnes-Jewish Hospital Pharmacy St. Peters 150 Entrance Way St. Peters, MO 633767/2/2024 2:12 PM
AddressesShipping AddressInsertChange Request Barnes Jewish Hospital dba Barnes-Jewish Hospital Pharmacy West County 10 Barnes West Drive MOB2, Suite 100 St. Louis, MO 631417/2/2024 2:12 PM
AddressesShipping AddressInsertChange Request Barnes Jewish Hospital dba Barnes-Jewish Hospital Pharmacy North County 1255 Graham Road Florissant, MO 630317/2/2024 2:12 PM
AddressesShipping AddressInsertChange Request Barnes Jewish Hospital 4533 Clayton Avenue St. Louis, MO 6311012/18/2023 4:16 PM
DetailsLast Recertification DateUpdateRecertification8/30/2022 10:51:22 AM9/5/2023 11:03:11 AM9/5/2023 11:03 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False2/24/2023 12:32 PM
Medicaid BillingMedicaid: NumberInsertChange Request 6001172382/24/2023 12:32 PM
Medicaid BillingMedicaid: StateInsertChange Request MO2/24/2023 12:32 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False2/24/2023 12:32 PM
Medicaid BillingMedicaid: NumberInsertChange Request 2373099370062/24/2023 12:32 PM
Medicaid BillingMedicaid: StateInsertChange Request IL2/24/2023 12:32 PM
Medicaid BillingNPI: NumberInsertChange Request 17500255652/24/2023 12:32 PM
Medicaid BillingNPI: StateInsertChange Request MO2/24/2023 12:32 PM
Medicaid BillingNPI: NumberInsertChange Request 17500255652/24/2023 12:32 PM
Medicaid BillingNPI: StateInsertChange Request IL2/24/2023 12:32 PM
AddressesShipping AddressInsertChange Request Barnes Jewish Hospital Advanced Family Care Pharmacy 1234 S Kingshighway Blvd Suite 1900 St. Louis, MO 631109/8/2022 1:28 PM
DetailsLast Recertification DateUpdateRecertification9/8/2021 9:07:13 AM8/30/2022 10:51:22 AM8/30/2022 10:51 AM
AddressesBilling AddressInsertChange Request Barnes Jewish Hospital 4249 Clayton Ave Ste 310 St. Louis, MO 631108/1/2022 4:25 PM
AddressesShipping AddressInsertChange Request Family Care Pharmacy at Barnes Jewish Hospital 1 Barnes Jewish Hospital Plaza St. Louis, MO 6311010/27/2021 8:02 AM
ContactsAuthorizing OfficialUpdateAO Change RequestKrieger, Mark CFO Barnes-Jewish Hospital 3143620605Irovic, Paul John Vice-president, Finance Barnes-Jewish Hospital 314265887410/12/2021 8:42 AM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False9/8/2021 9:07 AM
Medicaid BillingMedicaid: NumberInsertRecertification 2373099370029/8/2021 9:07 AM
Medicaid BillingMedicaid: StateInsertRecertification IL9/8/2021 9:07 AM
Medicaid BillingNPI: NumberDeleteRecertification1033132220 (MO) 9/8/2021 9:07 AM
Medicaid BillingNPI: NumberDeleteRecertification1033132220 (IL) 9/8/2021 9:07 AM
DetailsLast Recertification DateUpdateRecertification9/14/2020 11:42:43 AM9/8/2021 9:07:13 AM9/8/2021 9:07 AM
ContactsPrimary ContactUpdateChange RequestLeesman, Jonathan Pharmacy Manager Barnes-Jewish Hospital 3147473266Helton, Kristin Pharmacy Manager Barnes Jewish Hospital 314249768310/5/2020 11:16 AM
Medicaid BillingNPI: NumberDeleteRecertification1033132220 ( ) 9/14/2020 11:42 AM
Medicaid BillingNPI: NumberDeleteRecertification1649299827 ( ) 9/14/2020 11:42 AM
Medicaid BillingNPI: NumberDeleteRecertification1871609784 ( ) 9/14/2020 11:42 AM
Medicaid BillingNPI: NumberInsertRecertification 10331322209/14/2020 11:42 AM
Medicaid BillingNPI: StateInsertRecertification MO9/14/2020 11:42 AM
Medicaid BillingNPI: NumberInsertRecertification 16492998279/14/2020 11:42 AM
Medicaid BillingNPI: StateInsertRecertification MO9/14/2020 11:42 AM
Medicaid BillingNPI: NumberInsertRecertification 18716097849/14/2020 11:42 AM
Medicaid BillingNPI: StateInsertRecertification MO9/14/2020 11:42 AM
Medicaid BillingNPI: NumberInsertRecertification 10331322209/14/2020 11:42 AM
Medicaid BillingNPI: StateInsertRecertification IL9/14/2020 11:42 AM
Medicaid BillingNPI: NumberInsertRecertification 16492998279/14/2020 11:42 AM
Medicaid BillingNPI: StateInsertRecertification IL9/14/2020 11:42 AM
Medicaid BillingNPI: NumberInsertRecertification 18716097849/14/2020 11:42 AM
Medicaid BillingNPI: StateInsertRecertification IL9/14/2020 11:42 AM
DetailsLast Recertification DateUpdateRecertification9/2/2019 3:47:31 PM9/14/2020 11:42:43 AM9/14/2020 11:42 AM
ContactsAuthorizing OfficialUpdateChange RequestCannon, Robert President Barnes-Jewish Hospital 3142862118Krieger, Mark CFO Barnes-Jewish Hospital 31436206058/12/2020 7:52 AM
AddressesShipping AddressInsertChange Request Barnes-Jewish Hospital 425 South Euclid Avenue 2nd Floor Institute of Health (Pharmacy) 2105 Saint Louis, MO 6311011/12/2019 2:23 PM
AddressesShipping AddressDeleteChange RequestBarnes-Jewish Hospital 4924 Parkview 3rd Floor Saint Louis, MO 63110 11/12/2019 2:23 PM
DetailsLast Recertification DateUpdateRecertification8/30/2018 1:31:08 PM9/2/2019 3:47:31 PM9/2/2019 3:47 PM
Medicaid BillingMedicaid: NumberDeleteChange Request194630407 (AR) 4/22/2019 2:46 PM
Medicaid BillingMedicaid: NumberDeleteChange Request220496 (MS) 4/22/2019 2:46 PM
DetailsLast Recertification DateUpdateRecertification11/30/2017 10:55:44 AM8/30/2018 1:31:08 PM8/30/2018 1:31 PM
DetailsLast Recertification DateUpdateRecertification8/26/2016 12:00:00 AM11/30/2017 10:55:44 AM11/30/2017 10:55 AM
ContactsAuthorizing OfficialUpdate Cannon, Robert President 3142862118Cannon, Robert President Barnes-Jewish Hospital 314286211811/30/2017 10:47 AM
ContactsPrimary ContactUpdate Leesman, Jonathan Pharmacy Manager 3147473266Leesman, Jonathan Pharmacy Manager Barnes-Jewish Hospital 314747326610/3/2017 10:37 AM
ContactsPrimary ContactInsert  Leesman, Jonathan Pharmacy Manager 31474732667/24/2017 6:29 PM
ContactsAuthorizing OfficialInsert  Cannon, Robert President 31428621187/24/2017 6:29 PM
AddressesMain AddressInsert   One Barnes-Jewish Hospital Plaza St. Louis, MO 631107/24/2017 6:29 PM
AddressesShipping AddressInsert  Barnes-Jewish Hospital 4924 Parkview 3rd Floor Saint Louis, MO 631107/24/2017 6:29 PM
DetailsLast Recertification DateUpdate 8/13/2015 12:00:00 AM8/26/2016 12:00:00 AM8/26/2016 2:48 PM
DetailsLast Recertification DateUpdate 8/7/2014 12:00:00 AM8/13/2015 12:00:00 AM8/13/2015 2:26 PM
DetailsLast Recertification DateUpdate 8/27/2013 12:00:00 AM8/7/2014 12:00:00 AM8/7/2014 2:05 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False7/8/2014 8:07 AM
Medicaid BillingMedicaid: NumberInsert  2204967/8/2014 8:07 AM
Medicaid BillingMedicaid: StateInsert  MS7/8/2014 8:07 AM
Medicaid BillingMedicaid: NumberUpdate 2343099370012373099370015/2/2014 10:21 AM
Medicaid BillingNPI: NumberInsert  18716097845/2/2014 10:21 AM
DetailsLast Recertification DateUpdate 7/1/2012 12:00:00 AM8/27/2013 12:00:00 AM8/27/2013 9:17 AM
Medicaid BillingMedicaid: Is PrimaryInsert  False6/11/2013 2:24 PM
Medicaid BillingMedicaid: NumberInsert  0107242016/11/2013 2:24 PM
Medicaid BillingMedicaid: StateInsert  MO6/11/2013 2:24 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False6/11/2013 2:24 PM
Medicaid BillingMedicaid: NumberInsert  6007242236/11/2013 2:24 PM
Medicaid BillingMedicaid: StateInsert  MO6/11/2013 2:24 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False6/11/2013 2:24 PM
Medicaid BillingMedicaid: NumberInsert  2343099370016/11/2013 2:24 PM
Medicaid BillingMedicaid: StateInsert  IL6/11/2013 2:24 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False6/11/2013 2:24 PM
Medicaid BillingMedicaid: NumberInsert  1946304076/11/2013 2:24 PM
Medicaid BillingMedicaid: StateInsert  AR6/11/2013 2:24 PM
Medicaid BillingNPI: NumberInsert  10331322206/11/2013 2:24 PM
Medicaid BillingNPI: NumberInsert  16492998276/11/2013 2:24 PM
DetailsLast Recertification DateUpdate  7/1/2012 12:00:00 AM5/16/2012 7:54 AM
DetailsLast Recertification DateInsert   7/31/2009 4:37 PM
DetailsGrant NumberInsert   7/31/2009 4:37 PM
Details340B IDInsert  DSH2600327/31/2009 4:37 PM
DetailsIs Authorizing Official EHB DataInsert   7/31/2009 4:37 PM
DatesLast Date That 340B Drugs PurchasedInsert   7/31/2009 4:37 PM
DetailsMedicare Provider NumberInsert  2600327/31/2009 4:37 PM
DetailsEntity NameInsert  BARNES-JEWISH HOSPITAL7/31/2009 4:37 PM
DetailsProgram CodeInsert  DSH7/31/2009 4:37 PM
DetailsEntity SubnameInsert   7/31/2009 4:37 PM
DatesParticipating Approval DateInsert  4/23/2008 12:00:00 AM7/31/2009 4:37 PM
DetailsStateInsert  Active7/31/2009 4:37 PM
DatesRegistration DateInsert  4/23/2008 12:00:00 AM7/31/2009 4:37 PM
DatesSigned By DateInsert   7/31/2009 4:37 PM
DatesStart DateInsert  7/1/2004 12:00:00 AM7/31/2009 4:37 PM
TerminationsTermination CommentsInsert   7/31/2009 4:37 PM
TerminationsTermination DateInsert   7/31/2009 4:37 PM
TerminationsTermination Effective DateInsert   7/31/2009 4:37 PM
TerminationsTermination ReasonInsert   7/31/2009 4:37 PM
DetailsComments PublicInsert  7/15/04 MODIF ADDR (WAS 1 BARNES-JEWISH HOSPITAL DRIVE); 8/29/05 ADD MED #7/31/2009 4:37 PM