Covered Entity Details

DSH260183A SAINT FRANCIS MEDICAL CENTER (Active) - information as of 4/30/2025 12:01:12 AM

Main Details

Name

SAINT FRANCIS MEDICAL CENTER

Subdivision Name

Center for Digestive Diseases

Type

Disproportionate Share Hospital

Rural

340B ID

DSH260183A

Medicare Provider Number

260183

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/12/2016

Participating Start Date

1/1/2017

Participating Approval Date

10/25/2016

Last Recertification Date

8/29/2024

Contacts

Authorizing Official

Saint Francis Healthcare System
Lisa Ann Newcomer, Vice President - Regional Operations
(573) 331-5191

Primary Contact

Saint Francis Medical Center
SARAH JANE MIRGAUX, DIRECTOR OF PHARMACY
(573) 331-5251

Addresses

Street Address

28 South Mount Auburn Rd
Cape Girardeau, MO 63703

Billing Address

Saint Francis Medical Center
211 St. Francis Drive
Cape Girardeau, MO 63703-8399

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
MO	010160802	1467412726

Shipping Addresses

Shipping Address 1

Saint Francis Medical Center
211 St. Francis Drive
Cape Girardeau, MO 63703-8339

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
DSH260183A	Child	DSH	SAINT FRANCIS MEDICAL CENTER	Center for Digestive Diseases	28 South Mount Auburn Rd	Cape Girardeau	MO	Active
DSH260183B	Child	DSH	SAINT FRANCIS MEDICAL CENTER	Hospice	150 South Mount Auburn Road STE 344	Cape Girardeau	MO	Active
DSH260183C	Child	DSH	SAINT FRANCIS MEDICAL CENTER	SAINT FRANCIS MEDICAL CENTER - CAPE THORACIC & CARDIOVASCULAR SURGERY PBC	3250 GORDONVILLE RD STE 358	CAPE GIRARDEAU	MO	Active
DSH260183D	Child	DSH	SAINT FRANCIS MEDICAL CENTER	SAINT FRANCIS MEDICAL CENTER - Cape Cardiology Group	211 SAINT FRANCIS DR STE 15	CAPE GIRARDEAU	MO	Active
DSH260183E	Child	DSH	SAINT FRANCIS MEDICAL CENTER	CAPE GYNECOLOGIC ONCOLOGY - CAPE GYNECOLOGIC ONCOLOGY	211 SAINT FRANCIS DRIVE	CAPE GIRARDEAU	MO	Terminated
DSH260183F	Child	DSH	SAINT FRANCIS MEDICAL CENTER	SAINT FRANCIS MEDICAL CENTER - CAPE SPINE & NEUROSURGERY	150 S MT AUBURN RD STE 342	CAPE GIRARDEAU	MO	Active
DSH260183G	Child	DSH	SAINT FRANCIS MEDICAL CENTER	CAPE PHYSICIAN ASSOCIATES - Pediatrics	3250 GORDONVILLE RD STE 301	CAPE GIRARDEAU	MO	Active
DSH260183H	Child	DSH	SAINT FRANCIS MEDICAL CENTER	CAPE NEUROSURGICAL ASSOCIATES - Cape Neurosurgical Associates	150 S MOUNT AUBURN RD	CAPE GIRARDEAU	MO	Approved
DSH260183J	Child	DSH	SAINT FRANCIS MEDICAL CENTER	Cape Physician Associates - Primary Care - Cape Physician Associates - Primary Care	3250 Gordonville Road STE 401	Cape Girardeau	MO	Approved

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/24/2023 2:22:20 PM	8/29/2024 9:38:40 AM	8/29/2024 9:38 AM
Details	Last Recertification Date	Update	Recertification	9/7/2022 12:45:56 PM	8/24/2023 2:22:20 PM	8/24/2023 2:22 PM
Details	Last Recertification Date	Update	Recertification	9/2/2021 4:30:06 PM	9/7/2022 12:45:56 PM	9/7/2022 12:45 PM
Contacts	Authorizing Official	Update	AO Change Request	La Pierre, Stephanie Ann Chief Nursing Officer Saint Francis Healthcare System 5733315575	Newcomer, Lisa Ann Vice President - Regional Operations Saint Francis Healthcare System 5733315191	8/9/2022 12:06 PM
Details	Last Recertification Date	Update	Recertification	9/8/2020 12:21:04 PM	9/2/2021 4:30:06 PM	9/2/2021 4:30 PM
Medicaid Billing	NPI: State	Update	Recertification		MO	9/8/2020 12:21 PM
Details	Last Recertification Date	Update	Recertification	9/8/2019 2:23:57 PM	9/8/2020 12:21:04 PM	9/8/2020 12:21 PM
Contacts	Primary Contact	Update	Change Request	YOUNT, WILLIAM GRADY DIRECTOR OF PHARMACY Saint Francis Medical Center 5733315251	MIRGAUX, SARAH JANE DIRECTOR OF PHARMACY Saint Francis Medical Center 5733315251	7/13/2020 5:03 PM
Contacts	Authorizing Official	Update	AO Change Request	REESE, MARYANN PRESIDENT AND CEO Saint Francis Medical Center 5733313532	La Pierre, Stephanie Ann Chief Nursing Officer Saint Francis Healthcare System 5733315575	7/7/2020 9:15 AM
Details	Last Recertification Date	Update	Recertification	9/7/2018 2:37:40 PM	9/8/2019 2:23:57 PM	9/8/2019 2:23 PM
Details	Last Recertification Date	Update	Recertification	11/7/2017 4:24:55 PM	9/7/2018 2:37:40 PM	9/7/2018 2:37 PM
Details	Last Recertification Date	Update	Recertification		11/7/2017 4:24:55 PM	11/7/2017 4:24 PM
Contacts	Authorizing Official	Update		REESE, MARYANN PRESIDENT AND CEO 5733313532	REESE, MARYANN PRESIDENT AND CEO Saint Francis Medical Center 5733313532	9/19/2017 10:34 AM
Contacts	Primary Contact	Update		YOUNT, WILLIAM GRADY DIRECTOR OF PHARMACY 5733315251	YOUNT, WILLIAM GRADY DIRECTOR OF PHARMACY Saint Francis Medical Center 5733315251	9/18/2017 2:36 PM
Contacts	Authorizing Official	Update		BJELICH, STEVEN C. PRESIDENT AND CEO 5733315128	REESE, MARYANN PRESIDENT AND CEO 5733313532	9/11/2017 3:29 PM
Contacts	Primary Contact	Insert			YOUNT, WILLIAM GRADY DIRECTOR OF PHARMACY 5733315251	8/13/2017 9:37 AM
Addresses	Main Address	Insert			28 South Mount Auburn Rd Cape Girardeau, MO 63703	4/28/2017 6:13 PM
Addresses	Billing Address	Insert			Saint Francis Medical Center 211 St. Francis Drive Cape Girardeau, MO 63703-8399	4/28/2017 6:13 PM
Addresses	Shipping Address	Insert			Saint Francis Medical Center 211 St. Francis Drive Cape Girardeau, MO 63703-8339	4/28/2017 6:13 PM
Contacts	Authorizing Official	Insert			BJELICH, STEVEN C. PRESIDENT AND CEO 5733315128	4/28/2017 6:13 PM
Contacts	Signed By	Insert			BJELICH, STEVEN C. PRESIDENT AND CEO 5733315128	4/28/2017 6:13 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/28/2016 11:09 AM
Medicaid Billing	Medicaid: Number	Insert			010160802	11/28/2016 11:09 AM
Medicaid Billing	Medicaid: State	Insert			MO	11/28/2016 11:09 AM
Medicaid Billing	NPI: Number	Insert			1467412726	11/28/2016 11:09 AM
Dates	Participating Approval Date	Update			10/25/2016 12:00:00 AM	10/25/2016 1:11 PM
Details	State	Update		Pending	Active	10/25/2016 1:11 PM
Dates	Start Date	Update			1/1/2017 12:00:00 AM	10/25/2016 1:11 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_72941	DSH260183A	10/12/2016 12:01 PM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_72941	10/12/2016 11:06 AM
Details	Last Recertification Date	Insert				10/12/2016 11:06 AM
Details	Grant Number	Insert				10/12/2016 11:06 AM
Details	340B ID	Insert				10/12/2016 11:06 AM
Details	Is Authorizing Official EHB Data	Insert				10/12/2016 11:06 AM
Dates	Last Date That 340B Drugs Purchased	Insert				10/12/2016 11:06 AM
Details	Medicare Provider Number	Insert			260183	10/12/2016 11:06 AM
Details	Entity Name	Insert			SAINT FRANCIS MEDICAL CENTER	10/12/2016 11:06 AM
Details	Program Code	Insert			DSH	10/12/2016 11:06 AM
Details	Entity Subname	Insert			Center for Digestive Diseases	10/12/2016 11:06 AM
Dates	Participating Approval Date	Insert				10/12/2016 11:06 AM
Details	State	Insert			Pending	10/12/2016 11:06 AM
Dates	Registration Date	Insert			10/12/2016 12:00:00 AM	10/12/2016 11:06 AM
Dates	Signed By Date	Insert			10/12/2016 12:00:00 AM	10/12/2016 11:06 AM
Dates	Start Date	Insert				10/12/2016 11:06 AM
Terminations	Termination Comments	Insert				10/12/2016 11:06 AM
Terminations	Termination Date	Insert				10/12/2016 11:06 AM
Terminations	Termination Effective Date	Insert				10/12/2016 11:06 AM
Terminations	Termination Reason	Insert				10/12/2016 11:06 AM