Covered Entity Details

DSH260183 SAINT FRANCIS MEDICAL CENTER (Active) - information as of 4/29/2025 11:48:22 PM

Main Details

Name

SAINT FRANCIS MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

Rural

340B ID

DSH260183

Medicare Provider Number

260183

Additional Details

Current Program Status

Active

Registration Date

6/7/2010

Participating Start Date

7/1/2010

Participating Approval Date

6/14/2010

Last Recertification Date

8/30/2024

Contacts

Authorizing Official

Saint Francis Healthcare System
Lisa Ann Newcomer, Vice President - Regional Operations
(573) 331-5191

Primary Contact

Saint Francis Medical Center
SARAH JANE MIRGAUX, DIRECTOR OF PHARMACY
(573) 331-5251

Addresses

Street Address

211 SAINT FRANCIS DRIVE
CAPE GIRARDEAU, MO 63703

Billing Address
Same as Street Address

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
MO	10160802	1467412726

Shipping Addresses

Shipping Address 1

Healing Arts & Specialty Pharmacy
3250 Gordonville Rd #101
Cape Girardeau, MO 63703

Shipping Address 2

Saint Francis Specialty Pharmacy
211 Saint Francis Drive
Suite 01512
Cape Girardeau, MO 63703

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	HEALING ARTS PHARMACY	3250 GORDONVILLE ROAD		CAPE GIRADEAU	MO	63703	08/06/2010	08/06/2010	04/16/2018	04/18/2018
Contract Detail	MISSOURI CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10256	2161 WILLIAM ST.	CAPE GIRARDEAU	MO	63703	04/04/2025	07/01/2025		04/04/2025
Contract Detail	MISSOURI CVS PHARMACY, L.L.C.	CVS PHARMACY # 16385	202 SIEMERS DR	CAPE GIRARDEAU	MO	63701	04/04/2025	07/01/2025		04/04/2025
Contract Detail	MISSOURI CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #18074	19 S KINGSHIGHWAY	CAPE GIRARDEAU	MO	63703-5742	04/04/2025	07/01/2025		04/04/2025
Contract Detail	PHARMACY PLUS	150 S MT AUBURN RD STE 107		CAPE GIRARDEAU	MO	63703	08/06/2010	08/06/2010	04/18/2017	04/28/2017
Contract Detail	WAL-MART PHARMACY 10-0122	3051 EAST JACKSON BLVD		JACKSON	MO	63755	04/04/2025	07/01/2025		04/04/2025
Contract Detail	WAL-MART PHARMACY 10-0188	3439 WILLIAMS ST		CAPE GIRARDEAU	MO	63701	04/04/2025	07/01/2025		04/04/2025
Contract Detail	WALMART PHARMACY 10-7072	2021 INDEPENDENCE STREET		CAPE GIRARDEAU	MO	63703	04/04/2025	07/01/2025		04/04/2025

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH260183A	Child	DSH	SAINT FRANCIS MEDICAL CENTER	Center for Digestive Diseases	28 South Mount Auburn Rd	Cape Girardeau	MO	Active
DSH260183B	Child	DSH	SAINT FRANCIS MEDICAL CENTER	Hospice	150 South Mount Auburn Road STE 344	Cape Girardeau	MO	Active
DSH260183C	Child	DSH	SAINT FRANCIS MEDICAL CENTER	SAINT FRANCIS MEDICAL CENTER - CAPE THORACIC & CARDIOVASCULAR SURGERY PBC	3250 GORDONVILLE RD STE 358	CAPE GIRARDEAU	MO	Active
DSH260183D	Child	DSH	SAINT FRANCIS MEDICAL CENTER	SAINT FRANCIS MEDICAL CENTER - Cape Cardiology Group	211 SAINT FRANCIS DR STE 15	CAPE GIRARDEAU	MO	Active
DSH260183E	Child	DSH	SAINT FRANCIS MEDICAL CENTER	CAPE GYNECOLOGIC ONCOLOGY - CAPE GYNECOLOGIC ONCOLOGY	211 SAINT FRANCIS DRIVE	CAPE GIRARDEAU	MO	Terminated
DSH260183F	Child	DSH	SAINT FRANCIS MEDICAL CENTER	SAINT FRANCIS MEDICAL CENTER - CAPE SPINE & NEUROSURGERY	150 S MT AUBURN RD STE 342	CAPE GIRARDEAU	MO	Active
DSH260183G	Child	DSH	SAINT FRANCIS MEDICAL CENTER	CAPE PHYSICIAN ASSOCIATES - Pediatrics	3250 GORDONVILLE RD STE 301	CAPE GIRARDEAU	MO	Active
DSH260183H	Child	DSH	SAINT FRANCIS MEDICAL CENTER	CAPE NEUROSURGICAL ASSOCIATES - Cape Neurosurgical Associates	150 S MOUNT AUBURN RD	CAPE GIRARDEAU	MO	Approved
DSH260183J	Child	DSH	SAINT FRANCIS MEDICAL CENTER	Cape Physician Associates - Primary Care - Cape Physician Associates - Primary Care	3250 Gordonville Road STE 401	Cape Girardeau	MO	Approved

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/24/2023 2:47:28 PM	8/30/2024 9:22:33 AM	8/30/2024 9:22 AM
Addresses	Shipping Address	Insert	Change Request		Saint Francis Specialty Pharmacy 211 Saint Francis Drive Suite 01512 Cape Girardeau, MO 63703	7/22/2024 12:46 PM
Addresses	Shipping Address	Delete	Recertification	Healing Arts & Specialty Pharmacy 3250 Gordonville Rd #201 Cape Girardeau, MO 63703		8/24/2023 2:47 PM
Addresses	Shipping Address	Insert	Recertification		Healing Arts & Specialty Pharmacy 3250 Gordonville Rd #101 Cape Girardeau, MO 63703	8/24/2023 2:47 PM
Details	Last Recertification Date	Update	Recertification	9/7/2022 12:50:13 PM	8/24/2023 2:47:28 PM	8/24/2023 2:47 PM
Details	Last Recertification Date	Update	Recertification	9/13/2021 12:05:44 PM	9/7/2022 12:50:13 PM	9/7/2022 12:50 PM
Contacts	Authorizing Official	Update	AO Change Request	La Pierre, Stephanie Ann Chief Nursing Officer Saint Francis Healthcare System 5733315575	Newcomer, Lisa Ann Vice President - Regional Operations Saint Francis Healthcare System 5733315191	8/9/2022 12:06 PM
Details	Last Recertification Date	Update	Recertification	9/8/2020 12:20:24 PM	9/13/2021 12:05:44 PM	9/13/2021 12:05 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/8/2020 12:20 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		10160802	9/8/2020 12:20 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		MO	9/8/2020 12:20 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	010160802 (MO)		9/8/2020 12:20 PM
Medicaid Billing	NPI: State	Update	Recertification		MO	9/8/2020 12:20 PM
Details	Last Recertification Date	Update	Recertification	9/10/2019 9:03:07 AM	9/8/2020 12:20:24 PM	9/8/2020 12:20 PM
Contacts	Authorizing Official	Update	AO Change Request	REESE, MARYANN PRESIDENT AND CEO Saint Francis Medical Center 5733313532	La Pierre, Stephanie Ann Chief Nursing Officer Saint Francis Healthcare System 5733315575	7/7/2020 9:15 AM
Details	Last Recertification Date	Update	Recertification	9/10/2018 9:34:45 AM	9/10/2019 9:03:07 AM	9/10/2019 9:03 AM
Contacts	Primary Contact	Update	Change Request	YOUNT, WILLIAM GRADY DIRECTOR OF PHARMACY Saint Francis Medical Center 5733315251	MIRGAUX, SARAH JANE DIRECTOR OF PHARMACY Saint Francis Medical Center 5733315251	10/16/2018 9:38 AM
Details	Last Recertification Date	Update	Recertification	11/20/2017 3:19:39 PM	9/10/2018 9:34:45 AM	9/10/2018 9:34 AM
Addresses	Shipping Address	Insert	Change Request		Healing Arts & Specialty Pharmacy 3250 Gordonville Rd #201 Cape Girardeau, MO 63703	5/7/2018 9:37 AM
Details	Last Recertification Date	Update	Recertification	8/12/2016 12:00:00 AM	11/20/2017 3:19:39 PM	11/20/2017 3:19 PM
Contacts	Authorizing Official	Update		REESE, MARYANN PRESIDENT AND CEO 5733313532	REESE, MARYANN PRESIDENT AND CEO Saint Francis Medical Center 5733313532	9/19/2017 10:34 AM
Contacts	Primary Contact	Update		YOUNT, WILLIAM GRADY DIRECTOR OF PHARMACY 5733315251	YOUNT, WILLIAM GRADY DIRECTOR OF PHARMACY Saint Francis Medical Center 5733315251	9/18/2017 2:36 PM
Addresses	Main Address	Insert			211 SAINT FRANCIS DRIVE CAPE GIRARDEAU, MO 63703	8/13/2017 9:37 AM
Contacts	Authorizing Official	Update		BJELICH, STEVEN C. PRESIDENT AND CEO 5733315128	REESE, MARYANN PRESIDENT AND CEO 5733313532	8/13/2017 9:37 AM
Contacts	Primary Contact	Insert			YOUNT, WILLIAM GRADY DIRECTOR OF PHARMACY 5733315251	8/13/2017 9:37 AM
Contacts	Authorizing Official	Insert			BJELICH, STEVEN C. PRESIDENT AND CEO 5733315128	4/28/2017 6:13 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/28/2016 11:09 AM
Medicaid Billing	Medicaid: Number	Insert			010160802	11/28/2016 11:09 AM
Medicaid Billing	Medicaid: State	Insert			MO	11/28/2016 11:09 AM
Medicaid Billing	NPI: Number	Insert			1467412726	11/28/2016 11:09 AM
Details	Last Recertification Date	Update		8/13/2015 12:00:00 AM	8/12/2016 12:00:00 AM	8/12/2016 2:21 PM
Details	Last Recertification Date	Update		8/19/2014 12:00:00 AM	8/13/2015 12:00:00 AM	8/13/2015 3:01 PM
Details	Last Recertification Date	Update		8/19/2013 12:00:00 AM	8/19/2014 12:00:00 AM	8/19/2014 11:35 AM
Details	Last Recertification Date	Update		7/1/2012 12:00:00 AM	8/19/2013 12:00:00 AM	8/19/2013 10:30 AM
Details	Last Recertification Date	Update			7/1/2012 12:00:00 AM	5/16/2012 8:04 AM
Details	Last Recertification Date	Insert				2/17/2011 1:53 PM
Details	Grant Number	Insert				2/17/2011 1:53 PM
Details	340B ID	Insert			DSH260183	2/17/2011 1:53 PM
Details	Is Authorizing Official EHB Data	Insert				2/17/2011 1:53 PM
Dates	Last Date That 340B Drugs Purchased	Insert				2/17/2011 1:53 PM
Details	Medicare Provider Number	Insert			260183	2/17/2011 1:53 PM
Details	Entity Name	Insert			SAINT FRANCIS MEDICAL CENTER	2/17/2011 1:53 PM
Details	Program Code	Insert			DSH	2/17/2011 1:53 PM
Details	Entity Subname	Insert				2/17/2011 1:53 PM
Dates	Participating Approval Date	Insert			6/14/2010 12:00:00 AM	2/17/2011 1:53 PM
Details	State	Insert			Active	2/17/2011 1:53 PM
Dates	Registration Date	Insert			6/7/2010 12:00:00 AM	2/17/2011 1:53 PM
Dates	Signed By Date	Insert			5/21/2010 12:00:00 AM	2/17/2011 1:53 PM
Dates	Start Date	Insert			7/1/2010 12:00:00 AM	2/17/2011 1:53 PM
Terminations	Termination Comments	Insert				2/17/2011 1:53 PM
Terminations	Termination Date	Insert				2/17/2011 1:53 PM
Terminations	Termination Effective Date	Insert				2/17/2011 1:53 PM
Terminations	Termination Reason	Insert				2/17/2011 1:53 PM