Covered Entity Details

DSH520078E Ascension St. Francis Hospital, Inc. (Active) - information as of 6/9/2025 11:01:52 PM

Main Details

Name

Ascension St. Francis Hospital, Inc.

Subdivision Name

WHEATON FRANCISCAN HEALTHCARE / St Francis-MEDICAL ONCOLOGY-Reiman

Type

Disproportionate Share Hospital

Rural

340B ID

DSH520078E

Medicare Provider Number

520078

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/13/2015

Participating Start Date

1/1/2016

Participating Approval Date

11/9/2015

Last Recertification Date

8/22/2024

Contacts

Authorizing Official

Ascension Wisconsin Franklin & St. Francis Hospitals
Jonathon Matuszewski, Hospital President
(414) 647-5106

Primary Contact

Ascension WI
Cescilly Smith-Jenkins, 340B Program Director – Wisconsin
(414) 522-7533

Addresses

Street Address

7410 WEST RAWSON AVENUE
ST FRANCIS REIMAN CENTER FOR CANCER CARE
FRANKLIN, WI 53132-8274

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
WI		1073079455

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
DSH520078A	Child	DSH	WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS	ST FRANCIS WOMAN'S CENTER	3267 S. 16TH STREET	MILWAUKEE	WI	Terminated
DSH520078B	Child	DSH	WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS	ST FRANCIS SPORTS PERFORMANCE CENTER	2025 W. OKLAHOMA AVE	MILWAUKEE	WI	Terminated
DSH520078C	Child	DSH	Ascension St. Francis Hospital, Inc.	RAWSON PERFORMANCE CENTER	7400 W. RAWSON AVE	FRANKLIN	WI	Active
DSH520078D	Child	DSH	WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS	Wheaton Franciscan Healthcare-St Francis Reiman Center for Cancer Care	7410 West Rawson Ave	Franklin	WI	Terminated
DSH520078E	Child	DSH	Ascension St. Francis Hospital, Inc.	WHEATON FRANCISCAN HEALTHCARE / St Francis-MEDICAL ONCOLOGY-Reiman	7410 WEST RAWSON AVENUE	FRANKLIN	WI	Active
DSH520078F	Child	DSH	Ascension St. Francis Hospital, Inc.	WHEATON FRANCISCAN HEALTHCARE / St Francis-Radiation Oncology-Reiman	7410 WEST RAWSON AVENUE	FRANKLIN	WI	Active
DSH520078G	Child	DSH	Ascension St. Francis Hospital, Inc.	WHEATON FRANCISCAN HEALTHCARE / St Francis Wound Healing-Oklahoma Clinics	2025 WEST OKLAHOMA AVENUE	MILWAUKEE	WI	Terminated
DSH520078H	Child	DSH	ST. FRANCIS HOSPITAL	WHEATON FRANCISCAN HEALTHCARE / St Francis-MAMMOGRAPHY-Ohio Clinics	3267 S 16TH STREET	MILWAUKEE	WI	Terminated
DSH520078J	Child	DSH	WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS	WHEATON FRANCISCAN HEALTHCARE / St Francis-Rehab-Ohio Clinics	3267 S 16TH STREET	MILWAUKEE	WI	Terminated
DSH520078K	Child	DSH	WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS	WHEATON FRANCISCAN HEALTHCARE / St Francis-BEHAVIORAL HEALTH-Ohio Clinics	3267 S 16TH STREET	MILWAUKEE	WI	Terminated
DSH520078L	Child	DSH	WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS	WHEATON FRANCISCAN HEALTHCARE ST FR / St Francis-Metro Physician Outpatient Therapy- 2025 Oklahoma Ave Clinic	2025 W OKLAHOMA AVENUE	MILWAUKEE	WI	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/23/2023 1:46:22 PM	8/22/2024 3:15:40 PM	8/22/2024 3:15 PM
Contacts	Authorizing Official	Update	Change Request	Freitag, Vanessa Vice President, Pharmacy Ascension 7158971183	Matuszewski, Jonathon Hospital President Ascension Wisconsin Franklin & St. Francis Hospitals 4146475106	4/16/2024 12:10 PM
Contacts	Primary Contact	Update	Profile Change Request	Smith-Jenkins, Cescilly 340B Program Director – Wisconsin Ascension WI 4144996174	Smith-Jenkins, Cescilly 340B Program Director – Wisconsin Ascension WI 4145227533	11/28/2023 2:37 PM
Details	Last Recertification Date	Update	Recertification	9/12/2022 3:43:16 PM	8/23/2023 1:46:22 PM	8/23/2023 1:46 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1073079455 (IA)		12/7/2022 3:47 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1073079455 (IL)		12/7/2022 3:47 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1073079455 (MI)		12/7/2022 3:47 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1073079455 (MN)		12/7/2022 3:47 PM
Details	Last Recertification Date	Update	Recertification	9/8/2021 1:31:28 PM	9/12/2022 3:43:16 PM	9/12/2022 3:43 PM
Details	Last Recertification Date	Update	Recertification	9/10/2020 8:29:27 AM	9/8/2021 1:31:28 PM	9/8/2021 1:31 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1073079455	6/11/2021 4:57 PM
Medicaid Billing	NPI: State	Insert	Change Request		WI	6/11/2021 4:57 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1073079455	6/11/2021 4:57 PM
Medicaid Billing	NPI: State	Insert	Change Request		IA	6/11/2021 4:57 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1073079455	6/11/2021 4:57 PM
Medicaid Billing	NPI: State	Insert	Change Request		IL	6/11/2021 4:57 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1073079455	6/11/2021 4:57 PM
Medicaid Billing	NPI: State	Insert	Change Request		MI	6/11/2021 4:57 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1073079455	6/11/2021 4:57 PM
Medicaid Billing	NPI: State	Insert	Change Request		MN	6/11/2021 4:57 PM
Contacts	Authorizing Official	Update	Profile Change Request	Freitag, Vanessa Vice President, Ambulatory Services and Operational Integration Ascension 4144653711	Freitag, Vanessa Vice President, Pharmacy Ascension 7158971183	1/14/2021 3:35 PM
Contacts	Primary Contact	Update	Profile Change Request	Smith-Jenkins, Cescilly Regional Director, 340B Pharmacy Ascension WI 4148746268	Smith-Jenkins, Cescilly 340B Program Director – Wisconsin Ascension WI 4144996174	10/15/2020 7:25 PM
Details	Last Recertification Date	Update	Recertification	9/12/2019 2:14:21 PM	9/10/2020 8:29:27 AM	9/10/2020 8:29 AM
Details	Last Recertification Date	Update	Recertification	8/20/2018 11:43:50 AM	9/12/2019 2:14:21 PM	9/12/2019 2:14 PM
Details	Entity Name	Update	Change Request	WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS	Ascension St. Francis Hospital, Inc.	4/12/2019 4:46 PM
Details	Last Recertification Date	Update	Recertification	11/27/2017 5:14:02 PM	8/20/2018 11:43:50 AM	8/20/2018 11:43 AM
Details	Last Recertification Date	Update	Recertification	8/23/2016 12:00:00 AM	11/27/2017 5:14:02 PM	11/27/2017 5:14 PM
Details	Entity Name	Update	Recertification	ST. FRANCIS HOSPITAL	WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS	11/16/2017 11:08 AM
Contacts	Primary Contact	Update	Profile Change Request	Smith-Jenkins, Cescilly Regional Director, 340B Pharmacy Ascesnion WI 4148746268	Smith-Jenkins, Cescilly Regional Director, 340B Pharmacy Ascension WI 4148746268	10/10/2017 2:09 PM
Contacts	Authorizing Official	Update		Freitag, Vanessa Vice President, Ambulatory Services and Operational Integration 4144653711	Freitag, Vanessa Vice President, Ambulatory Services and Operational Integration Ascension 4144653711	10/5/2017 2:03 PM
Contacts	Primary Contact	Update		Smith-Jenkins, Cescilly Regional Director, 340B Pharmacy 4148746268	Smith-Jenkins, Cescilly Regional Director, 340B Pharmacy Ascesnion WI 4148746268	9/18/2017 5:55 PM
Contacts	Authorizing Official	Update		Baughman, Sharon Senior Vice President /Chief Nursing Officer 4144472719	Freitag, Vanessa Vice President, Ambulatory Services and Operational Integration 4144653711	8/13/2017 7:38 PM
Contacts	Primary Contact	Update		Olley, Phillip Pharmacy Manager 4146477163	Smith-Jenkins, Cescilly Regional Director, 340B Pharmacy 4148746268	8/13/2017 7:38 PM
Contacts	Signed By	Insert			Gresham, James Senior Vice President 4148746277	7/6/2017 1:16 PM
Addresses	Main Address	Insert			7410 WEST RAWSON AVENUE ST FRANCIS REIMAN CENTER FOR CANCER CARE FRANKLIN, WI 53132-8274	6/27/2017 8:02 AM
Contacts	Authorizing Official	Insert			Baughman, Sharon Senior Vice President /Chief Nursing Officer 4144472719	5/26/2017 8:02 AM
Contacts	Primary Contact	Update		Sabol, Kyle Pharmacist 4146475043	Olley, Phillip Pharmacy Manager 4146477163	2/9/2017 12:47 PM
Contacts	Primary Contact	Insert			Sabol, Kyle Pharmacist 4146475043	10/3/2016 8:49 PM
Details	Last Recertification Date	Update			8/23/2016 12:00:00 AM	8/23/2016 4:13 PM
Dates	Participating Approval Date	Update			11/9/2015 12:00:00 AM	11/9/2015 3:08 PM
Details	State	Update		Pending	Active	11/9/2015 3:08 PM
Dates	Start Date	Update			1/1/2016 12:00:00 AM	11/9/2015 3:08 PM
Details	340B ID	Update		DEL_11052015_55506	DSH520078E	11/5/2015 11:30 AM
Details	State	Update		Rejected	Pending	11/5/2015 11:30 AM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_55506	DEL_11052015_55506	11/5/2015 10:44 AM
Details	State	Update		Pending	Rejected	11/5/2015 10:44 AM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_55506	10/13/2015 6:48 PM
Details	Last Recertification Date	Insert				10/13/2015 6:48 PM
Details	Grant Number	Insert				10/13/2015 6:48 PM
Details	340B ID	Insert				10/13/2015 6:48 PM
Details	Is Authorizing Official EHB Data	Insert				10/13/2015 6:48 PM
Dates	Last Date That 340B Drugs Purchased	Insert				10/13/2015 6:48 PM
Details	Medicare Provider Number	Insert			520078	10/13/2015 6:48 PM
Details	Entity Name	Insert			ST. FRANCIS HOSPITAL	10/13/2015 6:48 PM
Details	Program Code	Insert			DSH	10/13/2015 6:48 PM
Details	Entity Subname	Insert			WHEATON FRANCISCAN HEALTHCARE / St Francis-MEDICAL ONCOLOGY-Reiman	10/13/2015 6:48 PM
Dates	Participating Approval Date	Insert				10/13/2015 6:48 PM
Details	State	Insert			Pending	10/13/2015 6:48 PM
Dates	Registration Date	Insert			10/13/2015 12:00:00 AM	10/13/2015 6:48 PM
Dates	Signed By Date	Insert			10/13/2015 12:00:00 AM	10/13/2015 6:48 PM
Dates	Start Date	Insert				10/13/2015 6:48 PM
Terminations	Termination Comments	Insert				10/13/2015 6:48 PM
Terminations	Termination Date	Insert				10/13/2015 6:48 PM
Terminations	Termination Effective Date	Insert				10/13/2015 6:48 PM
Terminations	Termination Reason	Insert				10/13/2015 6:48 PM