Covered Entity Details

SCH370049-03 STILLWATER MEDICAL CENTER AUTHORITY (Terminated) - information as of 5/3/2025 11:30:15 PM

Main Details

Name

STILLWATER MEDICAL CENTER AUTHORITY

Subdivision Name

STILLWATER MEDICAL CENTER - HOME HEALTH

Type

Sole Community Hospital

Rural

340B ID

SCH370049-03

Medicare Provider Number

370049

Outpatient Facility Provider Number

377204

Additional Details

Current Program Status

Terminated

Registration Date

6/13/2011

Participating Start Date

7/1/2011

Participating Approval Date

6/15/2011

Last Recertification Date

11/6/2017

Termination Date
Termination Reason

4/1/2018
Business decision by the Covered Entity

Contacts

Authorizing Official

Stillwater Medical Center Authority
ALAN LOVELACE, CHIEF FINANCIAL OFFICER
(405) 742-5729

Primary Contact

Stillwater Medical Center Authority
Leva Swim, VP
(405) 742-5729

Addresses

Street Address

824 SOUTH WALNUT
STILLWATER, OK 74074

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?
No

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
SCH370049-01	Child	SCH	STILLWATER MEDICAL CENTER AUTHORITY	STILLWATER MEDICAL CENTER - WOUND CARE CENTER	1301 W. 6TH, SUITE 102	STILLWATER	OK	Active
SCH370049-02	Child	SCH	STILLWATER MEDICAL CENTER AUTHORITY	STILLWATER MEDICAL CENTER - CARDIOLOGY CLINIC	1323 WEST SIXTH STREET	STILLWATER	OK	Active
SCH370049-03	Child	SCH	STILLWATER MEDICAL CENTER AUTHORITY	STILLWATER MEDICAL CENTER - HOME HEALTH	824 SOUTH WALNUT	STILLWATER	OK	Terminated
SCH370049-04	Child	SCH	STILLWATER MEDICAL CENTER AUTHORITY	STILLWATER MEDICAL CENTER - TOTAL HEALTH	1810 North PERKINS ROAD	STILLWATER	OK	Terminated
SCH370049-05	Child	SCH	STILLWATER MEDICAL CENTER AUTHORITY	Stillwater Medical Center - Outpatient Surgery	5200 West 6th	Stillwater	OK	Active
SCH370049-06	Child	SCH	STILLWATER MEDICAL CENTER AUTHORITY	The Cancer Center at SMC	1201 West Sixth	Stillwater	OK	Active
SCH370049-07	Child	SCH	STILLWATER MEDICAL CENTER AUTHORITY	Ortho Oklahoma, a Dvisiion of SMC	511 Windsor Drive	Stillwater	OK	Active
SCH370049-08	Child	SCH	STILLWATER MEDICAL CENTER AUTHORITY	Stillwater Surgical Associates	1301 W. 6th, Suite 105	Stillwater	OK	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	4/1/2018 12:00 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		1/1/2018 12:00:00 AM	1/17/2018 1:48 PM
Details	State	Update	Termination Request	Active	To Be Terminated	1/17/2018 1:48 PM
Terminations	Termination Comments	Update	Termination Request		We never purchased 340B drugs under this entity	1/17/2018 1:48 PM
Terminations	Termination Date	Update	Termination Request		4/1/2018 12:00:00 AM	1/17/2018 1:48 PM
Terminations	Termination Effective Date	Update	Termination Request		1/12/2018 12:00:00 AM	1/17/2018 1:48 PM
Terminations	Termination Reason	Update	Termination Request		Business decision by the Covered Entity	1/17/2018 1:48 PM
Details	Last Recertification Date	Update	Recertification	10/26/2017 9:11:10 AM	11/6/2017 1:39:27 PM	11/6/2017 1:39 PM
Contacts	Primary Contact	Insert	Recertification		Swim, Leva VP Stillwater Medical Center Authority 4057425729	10/26/2017 9:11 AM
Details	Last Recertification Date	Update	Recertification	8/22/2016 12:00:00 AM	10/26/2017 9:11:10 AM	10/26/2017 9:11 AM
Contacts	Authorizing Official	Update		LOVELACE, ALAN CHIEF FINANCIAL OFFICER 4057425729	LOVELACE, ALAN CHIEF FINANCIAL OFFICER Stillwater Medical Center Authority 4057425729	10/26/2017 8:52 AM
Contacts	Authorizing Official	Insert			LOVELACE, ALAN CHIEF FINANCIAL OFFICER 4057425729	7/10/2017 4:42 PM
Addresses	Main Address	Insert			824 SOUTH WALNUT STILLWATER, OK 74074	8/22/2016 9:15 AM
Details	Last Recertification Date	Update		8/14/2015 12:00:00 AM	8/22/2016 12:00:00 AM	8/22/2016 9:15 AM
Details	Last Recertification Date	Update		8/6/2014 12:00:00 AM	8/14/2015 12:00:00 AM	8/14/2015 11:10 AM
Details	Last Recertification Date	Update		9/12/2013 12:00:00 AM	8/6/2014 12:00:00 AM	8/6/2014 11:31 AM
Details	Last Recertification Date	Update			9/12/2013 12:00:00 AM	9/12/2013 4:43 PM
Details	Last Recertification Date	Insert				6/17/2011 10:01 AM
Details	Grant Number	Insert				6/17/2011 10:01 AM
Details	340B ID	Insert			SCH370049-03	6/17/2011 10:01 AM
Details	Is Authorizing Official EHB Data	Insert				6/17/2011 10:01 AM
Dates	Last Date That 340B Drugs Purchased	Insert				6/17/2011 10:01 AM
Details	Medicare Provider Number	Insert			370049	6/17/2011 10:01 AM
Details	Entity Name	Insert			STILLWATER MEDICAL CENTER AUTHORITY	6/17/2011 10:01 AM
Details	Program Code	Insert			SCH	6/17/2011 10:01 AM
Details	Entity Subname	Insert			STILLWATER MEDICAL CENTER - HOME HEALTH	6/17/2011 10:01 AM
Dates	Participating Approval Date	Insert			6/15/2011 12:00:00 AM	6/17/2011 10:01 AM
Details	State	Insert			Active	6/17/2011 10:01 AM
Dates	Registration Date	Insert			6/13/2011 12:00:00 AM	6/17/2011 10:01 AM
Dates	Signed By Date	Insert			4/25/2011 12:00:00 AM	6/17/2011 10:01 AM
Dates	Start Date	Insert			7/1/2011 12:00:00 AM	6/17/2011 10:01 AM
Terminations	Termination Comments	Insert				6/17/2011 10:01 AM
Terminations	Termination Date	Insert				6/17/2011 10:01 AM
Terminations	Termination Effective Date	Insert				6/17/2011 10:01 AM
Terminations	Termination Reason	Insert				6/17/2011 10:01 AM