| Details | Last Recertification Date | Update | Recertification | 8/22/2023 7:22:22 AM | 8/16/2024 11:37:04 AM | 8/16/2024 11:37 AM |
| Addresses | Main Address | Update | Recertification |
900 NORTH WASHINGTON STREET
DU QUOIN, IL 62832 |
905 NORTH WASHINGTON STREET
DU QUOIN, IL 62832 | 8/22/2023 7:22 AM |
| Details | Last Recertification Date | Update | Recertification | 9/7/2022 1:01:04 PM | 8/22/2023 7:22:22 AM | 8/22/2023 7:22 AM |
| Addresses | Main Address | Update | Change Request |
900 NORTH WASHINGTON STREET
DUQUOIN, IL 62832 |
900 NORTH WASHINGTON STREET
DU QUOIN, IL 62832 | 1/19/2023 8:06 AM |
| Addresses | Billing Address | Update | Change Request | MARSHALL BROWNING HOSPITAL
P.O. BOX 192
DUQUOIN, IL 62832 | MARSHALL BROWNING HOSPITAL ASSOCATION
P.O. BOX 192
DU QUOIN, IL 62832 | 1/19/2023 8:06 AM |
| Details | Entity Name | Update | Change Request | MARSHALL BROWNING HOSPITAL | MARSHALL BROWNING HOSPITAL ASSOCIATION | 1/19/2023 8:06 AM |
| Details | Last Recertification Date | Update | Recertification | 8/25/2021 2:55:06 PM | 9/7/2022 1:01:04 PM | 9/7/2022 1:01 PM |
| Contacts | Authorizing Official | Update | AO Change Request | Spour, Larry Francis
CEO
Marshall Browning Hospital
6185421042 | Calderon, Harold
CFO
Marshall Browning Hospital Association
6185422146-1420 | 9/1/2022 4:18 PM |
| Contacts | Authorizing Official | Update | Profile Change Request | Spour, Larry Francis
COO
Marshall Browning Hospital
6185421042 | Spour, Larry Francis
CEO
Marshall Browning Hospital
6185421042 | 4/15/2022 12:13 PM |
| Contacts | Primary Contact | Update | Change Request | Schubert, Tracy
Ancillary Informatics Specialist
Marshall Browning Hospital
6185421036 | Schubert, Tracy Lynn
Ancillary Informatics Specialist
Marshall Browning Hospital
6185421036 | 9/9/2021 12:40 PM |
| Details | Last Recertification Date | Update | Recertification | 8/18/2020 9:24:21 AM | 8/25/2021 2:55:06 PM | 8/25/2021 2:55 PM |
| Contacts | Authorizing Official | Update | AO Change Request | Eaves, Daniel
CEO
Marshall Browning Hospital
6185421042 | Spour, Larry Francis
COO
Marshall Browning Hospital
6185421042 | 8/25/2021 12:32 PM |
| Contacts | Primary Contact | Update | Profile Change Request | Schubert, Tracy
Ancillary Informatics Specialist
Marshall Browning Hospital
6185422146 | Schubert, Tracy
Ancillary Informatics Specialist
Marshall Browning Hospital
6185421036 | 8/18/2020 5:34 PM |
| Contacts | Primary Contact | Update | Recertification | Schandl, Brian
CIO
Marshall Browning Hospital
6185421055 | Schubert, Tracy
Ancillary Informatics Specialist
Marshall Browning Hospital
6185422146 | 8/18/2020 9:24 AM |
| Details | Last Recertification Date | Update | Recertification | 8/26/2019 10:27:49 AM | 8/18/2020 9:24:21 AM | 8/18/2020 9:24 AM |
| Details | Last Recertification Date | Update | Recertification | 8/21/2018 8:39:55 AM | 8/26/2019 10:27:49 AM | 8/26/2019 10:27 AM |
| Details | Last Recertification Date | Update | Recertification | 11/29/2017 12:58:56 PM | 8/21/2018 8:39:55 AM | 8/21/2018 8:39 AM |
| Contacts | Primary Contact | Insert | Recertification | | Schandl, Brian
CIO
Marshall Browning Hospital
6185421055 | 11/29/2017 12:58 PM |
| Details | Last Recertification Date | Update | Recertification | | 11/29/2017 12:58:56 PM | 11/29/2017 12:58 PM |
| Contacts | Authorizing Official | Insert | AO Change Request | | Eaves, Daniel
CEO
Marshall Browning Hospital
6185421042 | 11/29/2017 12:57 PM |
| Contacts | Signed By | Update | | Harsy, Brice D.
Chief Financial Officer
6185421005 | Harsy, Brice D.
Chief Financial Officer
Marshall Browning Hospital
6185421005 | 10/30/2017 3:44 PM |
| Contacts | Signed By | Insert | | | Harsy, Brice D.
Chief Financial Officer
6185421005 | 10/17/2016 1:15 PM |
| Addresses | Main Address | Insert | | |
900 NORTH WASHINGTON STREET
DUQUOIN, IL 62832 | 10/17/2016 1:15 PM |
| Addresses | Billing Address | Insert | | | MARSHALL BROWNING HOSPITAL
P.O. BOX 192
DUQUOIN, IL 62832 | 10/17/2016 1:15 PM |
| Dates | Participating Approval Date | Update | | | 10/17/2016 12:00:00 AM | 10/17/2016 1:15 PM |
| Details | State | Update | | Pending | Active | 10/17/2016 1:15 PM |
| Dates | Start Date | Update | | | 1/1/2017 12:00:00 AM | 10/17/2016 1:15 PM |
| Details | 340B ID | Update | | OUTPATIENT_ONLINE_REG_72857 | CAH141331-01 | 10/11/2016 2:29 PM |
| Details | 340B ID | Update | | | OUTPATIENT_ONLINE_REG_72857 | 10/11/2016 1:48 PM |
| Details | Last Recertification Date | Insert | | | | 10/11/2016 1:48 PM |
| Details | Grant Number | Insert | | | | 10/11/2016 1:48 PM |
| Details | 340B ID | Insert | | | | 10/11/2016 1:48 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 10/11/2016 1:48 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 10/11/2016 1:48 PM |
| Details | Medicare Provider Number | Insert | | | 141331 | 10/11/2016 1:48 PM |
| Details | Entity Name | Insert | | | MARSHALL BROWNING HOSPITAL | 10/11/2016 1:48 PM |
| Details | Program Code | Insert | | | CAH | 10/11/2016 1:48 PM |
| Details | Entity Subname | Insert | | | MARSHALL BROWNING PHYSICIAN CLINIC | 10/11/2016 1:48 PM |
| Dates | Participating Approval Date | Insert | | | | 10/11/2016 1:48 PM |
| Details | State | Insert | | | Pending | 10/11/2016 1:48 PM |
| Dates | Registration Date | Insert | | | 10/11/2016 12:00:00 AM | 10/11/2016 1:48 PM |
| Dates | Signed By Date | Insert | | | 10/11/2016 12:00:00 AM | 10/11/2016 1:48 PM |
| Dates | Start Date | Insert | | | | 10/11/2016 1:48 PM |
| Terminations | Termination Comments | Insert | | | | 10/11/2016 1:48 PM |
| Terminations | Termination Date | Insert | | | | 10/11/2016 1:48 PM |
| Terminations | Termination Effective Date | Insert | | | | 10/11/2016 1:48 PM |
| Terminations | Termination Reason | Insert | | | | 10/11/2016 1:48 PM |