| 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 | 9/3/2024 2:24 PM |
| Addresses | Main Address | Update | Recertification |
310 E. Walnut
Garden City, KS 67846 |
310 E Walnut St
Garden City, KS 67846 | 9/3/2024 2:24 PM |
| Details | Last Recertification Date | Update | Recertification | 8/23/2023 9:34:49 AM | 9/3/2024 2:24:50 PM | 9/3/2024 2:24 PM |
| 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 9:49:36 AM | 8/23/2023 9:34:49 AM | 8/23/2023 9:34 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 2:24:49 PM | 8/30/2022 9:49:36 AM | 8/30/2022 9:49 AM |
| Details | Last Recertification Date | Update | Recertification | 8/17/2020 3:47:04 PM | 8/18/2021 2:24:49 PM | 8/18/2021 2:24 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 11:07:14 AM | 8/17/2020 3:47:04 PM | 8/17/2020 3:47 PM |
| Addresses | Billing Address | Insert | Change Request | | Centura Health
PO Box 372660
Denver, CO 80237 | 9/16/2019 3:22 PM |
| Addresses | Shipping Address | Insert | Change Request | | St. Catherine Hospital
401 E. Spruce
Garden City, KS 67846 | 9/16/2019 3:22 PM |
| Addresses | Main Address | Update | Change Request |
410 E. Walnut
Garden City, KS 67846 |
310 E. Walnut
Garden City, KS 67846 | 9/16/2019 3:22 PM |
| Details | Last Recertification Date | Update | Recertification | 8/20/2018 11:35:11 AM | 8/26/2019 11:07:14 AM | 8/26/2019 11:07 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 2:12 PM |
| Details | Last Recertification Date | Update | Recertification | 11/16/2017 4:16:27 PM | 8/20/2018 11:35:11 AM | 8/20/2018 11:35 AM |
| Details | Last Recertification Date | Update | Recertification | 8/15/2016 12:00:00 AM | 11/16/2017 4:16:27 PM | 11/16/2017 4:16 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 | | |
410 E. Walnut
Garden City, KS 67846 | 8/15/2016 12:23 PM |
| Contacts | Signed By | Insert | | | Vaughan, Amanda
CFO
6202722554 | 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 | | | 8/28/2013 6:49:38 AM | 8/28/2013 6:49 AM |
| Details | 340B ID | Update | | ISJMSCH170023-02 | SCH170023-02 | 10/9/2012 1:20 PM |
| Dates | Participating Approval Date | Update | | | 10/9/2012 12:00:00 AM | 10/9/2012 1:20 PM |
| Details | State | Update | | Pending | Active | 10/9/2012 1:20 PM |
| Dates | Start Date | Update | | | 1/1/2013 12:00:00 AM | 10/9/2012 1:20 PM |
| Details | 340B ID | Update | | JM092612I | ISJMSCH170023-02 | 10/4/2012 2:43 PM |
| Details | 340B ID | Update | | OUTPATIENT_ONLINE_REG | JM092612I | 9/26/2012 10:17 PM |
| Details | Last Recertification Date | Insert | | | | 9/11/2012 4:17 PM |
| Details | Grant Number | Insert | | | | 9/11/2012 4:17 PM |
| Details | 340B ID | Insert | | | OUTPATIENT_ONLINE_REG | 9/11/2012 4:17 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 9/11/2012 4:17 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 9/11/2012 4:17 PM |
| Details | Medicare Provider Number | Insert | | | 170023 | 9/11/2012 4:17 PM |
| Details | Entity Name | Insert | | | ST. CATHERINE HOSPITAL | 9/11/2012 4:17 PM |
| Details | Program Code | Insert | | | SCH | 9/11/2012 4:17 PM |
| Details | Entity Subname | Insert | | | Wound Care Clinic | 9/11/2012 4:17 PM |
| Dates | Participating Approval Date | Insert | | | | 9/11/2012 4:17 PM |
| Details | State | Insert | | | Pending | 9/11/2012 4:17 PM |
| Dates | Registration Date | Insert | | | 9/11/2012 12:00:00 AM | 9/11/2012 4:17 PM |
| Dates | Signed By Date | Insert | | | 9/11/2012 12:00:00 AM | 9/11/2012 4:17 PM |
| Dates | Start Date | Insert | | | | 9/11/2012 4:17 PM |
| Terminations | Termination Comments | Insert | | | | 9/11/2012 4:17 PM |
| Terminations | Termination Date | Insert | | | | 9/11/2012 4:17 PM |
| Terminations | Termination Effective Date | Insert | | | | 9/11/2012 4:17 PM |
| Terminations | Termination Reason | Insert | | | | 9/11/2012 4:17 PM |