Covered Entity Details

SCH170023-01 St. Catherine Hospital - Garden City (Active) - information as of 6/27/2025 3:26:43 AM

Main Details

Name

St. Catherine Hospital - Garden City

Subdivision Name

SIENA MEDICAL CLINIC

Type

Sole Community Hospital

Rural

Yes

340B ID

SCH170023-01

Medicare Provider Number

170023

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

9/14/2010

Participating Start Date

9/15/2010

Participating Approval Date

9/15/2010

Last Recertification Date

9/5/2024

Contacts

Authorizing Official

CommonSpirit Health
Shawna Roark, VP of Finance & CFO
(620) 272-2551

Primary Contact

CommonSpirit Health
Samantha Morgan, System Manager, 340B Mountain Region
(303) 673-7380

Addresses

Street Address

311 E Spruce St
Garden City, KS 67846

Billing Address

CommonSpirit Health
PO Box 372660
Denver, CO 80237

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?
No

Shipping Addresses

Shipping Address 1

St. Catherine Hospital - Garden City
401 E. Spruce
Garden City, KS 67846

Shipping Address 2

CommonSpirit Health - Central Distribution Center
2551 W 84th Ave
Westminster, CO 80031

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
Contract Detail	PLAZA PHARMACY INC	911 N MAIN ST		GARDEN CITY	KS	67846-5561	11/28/2012	11/28/2012		06/01/2019	05/06/2020

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
SCH170023-01	Child	SCH	St. Catherine Hospital - Garden City	SIENA MEDICAL CLINIC	311 E Spruce St	Garden City	KS	Active
SCH170023-02	Child	SCH	St. Catherine Hospital - Garden City	Wound Care Clinic	310 E Walnut St	Garden City	KS	Active
SCH170023-04	Child	SCH	ST. CATHERINE HOSPITAL	ST CATHERINE HOSPITAL - Occupational Medicine - Siena Medical Clinic	311 E SPRUCE ST	GARDEN CITY	KS	Terminated
SCH170023-05	Child	SCH	St. Catherine Hospital - Garden City	ST CATHERINE HOSPITAL - Internal Medicine - Siena Medical Clinic	311 E Spruce St	Garden City	KS	Active
SCH170023-06	Child	SCH	St. Catherine Hospital - Garden City	ST CATHERINE HOSPITAL - Neurology - Siena Medical Clinic	311 E Spruce St	GARDEN CITY	KS	Active
SCH170023-07	Child	SCH	St. Catherine Hospital - Garden City	ST CATHERINE HOSPITAL - Nephrology - Siena Medical Clinic	311 E Spruce St	Garden City	KS	Active
SCH170023-08	Child	SCH	St. Catherine Hospital - Garden City	ST CATHERINE HOSPITAL - General Surgery - Siena Medical Clinic	311 E Spruce St	Garden City	KS	Active
SCH170023-09	Child	SCH	St. Catherine Hospital - Garden City	ST CATHERINE HOSPITAL - Family Medicine - Siena Medical Clinic	311 E Spruce St	Garden City	KS	Active
SCH170023-10	Child	SCH	St. Catherine Hospital - Garden City	ST CATHERINE HOSPITAL - Pediatrics - Siena Medical Clinic	311 E Spruce St	Garden City	KS	Active
SCH170023-11	Child	SCH	St. Catherine Hospital - Garden City	ST CATHERINE HOSPITAL - Orthopedics - Siena Medical Clinic	311 E Spruce St	Garden City	KS	Active
SCH170023-12	Child	SCH	St. Catherine Hospital - Garden City	ST CATHERINE HOSPITAL - Podiatry - Siena Medical Clinic	311 E Spruce St	Garden City	KS	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Entity Name	Update	Change Request	Centura St. Catherine Hospital - Garden City	St. Catherine Hospital - Garden City	12/9/2024 7:15 AM
Addresses	Billing Address	Update	Recertification	Centura Health PO Box 372660 Denver, CO 80237	CommonSpirit Health PO Box 372660 Denver, CO 80237	9/5/2024 9:24 AM
Addresses	Shipping Address	Delete	Recertification	St. Catherine Hospital 401 E. Spruce Garden City, KS 67846		9/5/2024 9:24 AM
Addresses	Shipping Address	Insert	Recertification		St. Catherine Hospital - Garden City 401 E. Spruce Garden City, KS 67846	9/5/2024 9:24 AM
Addresses	Shipping Address	Insert	Recertification		CommonSpirit Health - Central Distribution Center 2551 W 84th Ave Westminster, CO 80031	9/5/2024 9:24 AM
Addresses	Main Address	Update	Recertification	311 E. SPRUCE GARDEN CITY, KS 67846	311 E Spruce St Garden City, KS 67846	9/5/2024 9:24 AM
Details	Last Recertification Date	Update	Recertification	8/14/2023 11:24:17 AM	9/5/2024 9:24:25 AM	9/5/2024 9:24 AM
Contacts	Primary Contact	Update	Profile Change Request	Morgan, Samantha Regional Manager, 340B Program CommonSpirit Health 3036737380	Morgan, Samantha System Manager, 340B Mountain Region CommonSpirit Health 3036737380	8/20/2024 1:07 PM
Contacts	Authorizing Official	Update	Change Request	Roark, Shawna CFO St. Catherine Hospital 6202722551	Roark, Shawna VP of Finance & CFO CommonSpirit Health 6202722551	8/1/2024 9:53 AM
Contacts	Primary Contact	Update	Profile Change Request	Morgan, Samantha Director, Enterprise 340B Program Centura Health 3036737380	Morgan, Samantha Regional Manager, 340B Program CommonSpirit Health 3036737380	7/25/2024 4:28 PM
Details	Last Recertification Date	Update	Recertification	8/30/2022 9:48:14 AM	8/14/2023 11:24:17 AM	8/14/2023 11:24 AM
Contacts	Authorizing Official	Update	Change Request	VAUGHAN, AMANDA CFO St. Catherine Hospital 6202722554	Roark, Shawna CFO St. Catherine Hospital 6202722551	7/11/2023 10:27 AM
Contacts	Primary Contact	Update	Profile Change Request	Morgan, Samantha 340B Program Manager Centura Health 3036737380	Morgan, Samantha Director, Enterprise 340B Program Centura Health 3036737380	5/25/2023 12:41 PM
Details	Entity Name	Update	Recertification	ST. CATHERINE HOSPITAL	Centura St. Catherine Hospital - Garden City	8/31/2022 4:06 PM
Details	Last Recertification Date	Update	Recertification	8/18/2021 2:23:37 PM	8/30/2022 9:48:14 AM	8/30/2022 9:48 AM
Details	Last Recertification Date	Update	Recertification	8/17/2020 3:45:18 PM	8/18/2021 2:23:37 PM	8/18/2021 2:23 PM
Contacts	Primary Contact	Update	Group Change Request	POLITO, VINNY SYSTEM DIRECTOR AMB PHARMACY Centura Health 3036731014	Morgan, Samantha 340B Program Manager Centura Health 3036737380	7/15/2021 10:06 AM
Details	Last Recertification Date	Update	Recertification	8/26/2019 11:04:04 AM	8/17/2020 3:45:18 PM	8/17/2020 3:45 PM
Addresses	Billing Address	Insert	Change Request		Centura Health PO Box 372660 Denver, CO 80237	9/16/2019 3:23 PM
Addresses	Shipping Address	Insert	Change Request		St. Catherine Hospital 401 E. Spruce Garden City, KS 67846	9/16/2019 3:23 PM
Details	Last Recertification Date	Update	Recertification	8/20/2018 11:34:50 AM	8/26/2019 11:04:04 AM	8/26/2019 11:04 AM
Contacts	Primary Contact	Update	Change Request	ROARK, SHAWNA FINANCIAL ANALYST St. Catherine Hospital 6202722551	POLITO, VINNY SYSTEM DIRECTOR AMB PHARMACY Centura Health 3036731014	5/1/2019 2:13 PM
Details	Last Recertification Date	Update	Recertification	11/16/2017 4:15:31 PM	8/20/2018 11:34:50 AM	8/20/2018 11:34 AM
Details	Last Recertification Date	Update	Recertification	8/15/2016 12:00:00 AM	11/16/2017 4:15:31 PM	11/16/2017 4:15 PM
Contacts	Authorizing Official	Update		VAUGHAN, AMANDA CFO 6202722554	VAUGHAN, AMANDA CFO St. Catherine Hospital 6202722554	11/16/2017 4:04 PM
Contacts	Primary Contact	Update		ROARK, SHAWNA FINANCIAL ANALYST 6202722551	ROARK, SHAWNA FINANCIAL ANALYST St. Catherine Hospital 6202722551	11/16/2017 4:00 PM
Contacts	Authorizing Official	Insert			VAUGHAN, AMANDA CFO 6202722554	6/13/2017 10:41 AM
Contacts	Primary Contact	Insert			ROARK, SHAWNA FINANCIAL ANALYST 6202722551	6/13/2017 10:41 AM
Addresses	Main Address	Insert			311 E. SPRUCE GARDEN CITY, KS 67846	8/15/2016 12:23 PM
Details	Last Recertification Date	Update		8/10/2015 12:00:00 AM	8/15/2016 12:00:00 AM	8/15/2016 12:23 PM
Details	Last Recertification Date	Update		8/25/2014 12:00:00 AM	8/10/2015 12:00:00 AM	8/10/2015 2:26 PM
Details	Last Recertification Date	Update		8/28/2013 6:49:38 AM	8/25/2014 12:00:00 AM	8/25/2014 8:17 AM
Details	Last Recertification Date	Update		7/1/2012 12:00:00 AM	8/28/2013 6:49:38 AM	8/28/2013 6:49 AM
Details	Last Recertification Date	Update			7/1/2012 12:00:00 AM	4/25/2012 7:28 AM
Details	Last Recertification Date	Insert				9/15/2010 2:51 PM
Details	Grant Number	Insert				9/15/2010 2:51 PM
Details	340B ID	Insert			SCH170023-01	9/15/2010 2:51 PM
Details	Is Authorizing Official EHB Data	Insert				9/15/2010 2:51 PM
Dates	Last Date That 340B Drugs Purchased	Insert				9/15/2010 2:51 PM
Details	Medicare Provider Number	Insert			170023	9/15/2010 2:51 PM
Details	Entity Name	Insert			ST. CATHERINE HOSPITAL	9/15/2010 2:51 PM
Details	Program Code	Insert			SCH	9/15/2010 2:51 PM
Details	Entity Subname	Insert			SIENA MEDICAL CLINIC	9/15/2010 2:51 PM
Dates	Participating Approval Date	Insert			9/15/2010 12:00:00 AM	9/15/2010 2:51 PM
Details	State	Insert			Active	9/15/2010 2:51 PM
Dates	Registration Date	Insert			9/14/2010 12:00:00 AM	9/15/2010 2:51 PM
Dates	Signed By Date	Insert			9/10/2010 12:00:00 AM	9/15/2010 2:51 PM
Dates	Start Date	Insert			9/15/2010 12:00:00 AM	9/15/2010 2:51 PM
Terminations	Termination Comments	Insert				9/15/2010 2:51 PM
Terminations	Termination Date	Insert				9/15/2010 2:51 PM
Terminations	Termination Effective Date	Insert				9/15/2010 2:51 PM
Terminations	Termination Reason	Insert				9/15/2010 2:51 PM