Covered Entity Details

DSH180143H SAINT JOSEPH EAST (Active) - information as of 6/3/2025 12:02:11 PM

Main Details

Name

SAINT JOSEPH EAST

Subdivision Name

Breast Care Center - Diagnostic Mamography Services

Type

Disproportionate Share Hospital

Rural

340B ID

DSH180143H

Medicare Provider Number

180143

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/2/2018

Participating Start Date

10/1/2018

Participating Approval Date

7/11/2018

Last Recertification Date

8/29/2024

Contacts

Authorizing Official

Saint Joseph East
Jennifer Camille Nolan, President
(859) 967-5618

Primary Contact

Saint Joseph East
Joseph Lee Osborne, Pharmacy Manager
(859) 967-5576

Addresses

Street Address

160 N Eagle Creek Drive
101
Lexington, KY 40509

Billing Address

Commonspirit Health
PO Box 636000
Littleton, CO 80163

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
KY	01022557	1447457775

Shipping Addresses

Shipping Address 1

Saint Joseph East
150 N Eagle Creek Dr
Lexington, KY 40509

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
DSH180143A	Child	DSH	SAINT JOSEPH EAST	Saint Joseph East Hemoc	3470 Blazer Parkway	Lexington	KY	Active
DSH180143B	Child	DSH	SAINT JOSEPH EAST	Saint Joseph East Endo Unit	160 North Eagle Creek Dr Suite 410	Lexington	KY	Terminated
DSH180143C	Child	DSH	SAINT JOSEPH EAST	Saint Joseph East Pain Management Center	3470 Blazer Parkway	Lexington	KY	Terminated
DSH180143D	Child	DSH	SAINT JOSEPH EAST	Saint Joseph East Women's Hospital / OB Emergency Department	170 N Eagle Creek Drive	Lexington	KY	Active
DSH180143E	Child	DSH	SAINT JOSEPH EAST	Transformation Care at Saint Joseph East / Hepatitis	120 North Eagle Creek Suite 103	Lexington	KY	Terminated
DSH180143F	Child	DSH	SAINT JOSEPH EAST	KentuckyOne Health Heart and Vascular Imaging	1042 Center Drive	Richmond	KY	Terminated
DSH180143G	Child	DSH	SAINT JOSEPH EAST	Outpatient Treatment - MS, GI, RA	3470 Blazer Parkway	Lexington	KY	Terminated
DSH180143H	Child	DSH	SAINT JOSEPH EAST	Breast Care Center - Diagnostic Mamography Services	160 N Eagle Creek Drive	Lexington	KY	Active
DSH180143J	Child	DSH	SAINT JOSEPH EAST	Saint Joseph Hematology Oncology - Oncology	701 Bob-O-Link Drive	LEXINGTON	KY	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/24/2023 11:35:57 AM	8/29/2024 1:06:35 PM	8/29/2024 1:06 PM
Addresses	Billing Address	Update	Change Request	Saint Joseph East 150 N Eagle Creek Dr Lexington, KY 40509	Commonspirit Health PO Box 636000 Littleton, CO 80163	11/7/2023 10:13 AM
Addresses	Shipping Address	Insert	Change Request		Saint Joseph East 150 N Eagle Creek Dr Lexington, KY 40509	11/7/2023 10:13 AM
Contacts	Authorizing Official	Update	AO Change Request	Taylor, Lonnie Ralph VP Patient Care Services/Operations CHI Saint Joseph's Hospital East 8599675758	Nolan, Jennifer Camille President Saint Joseph East 8599675618	10/17/2023 7:49 AM
Details	Last Recertification Date	Update	Recertification	8/26/2022 3:05:25 PM	8/24/2023 11:35:57 AM	8/24/2023 11:35 AM
Details	Last Recertification Date	Update	Recertification	8/18/2021 7:58:48 AM	8/26/2022 3:05:25 PM	8/26/2022 3:05 PM
Contacts	Primary Contact	Update	Change Request	Pearcy, Ryan 340B Division Manager Catholic Health Initiatives 8592295654	Osborne, Joseph Lee Pharmacy Manager Saint Joseph East 8599675576	9/7/2021 9:10 AM
Details	Last Recertification Date	Update	Recertification	8/24/2020 1:45:45 PM	8/18/2021 7:58:48 AM	8/18/2021 7:58 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1447457775	8/24/2020 1:45 PM
Medicaid Billing	NPI: State	Insert	Recertification		KY	8/24/2020 1:45 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1447457775 ( )		8/24/2020 1:45 PM
Details	Last Recertification Date	Update	Recertification	8/28/2019 11:04:58 AM	8/24/2020 1:45:45 PM	8/24/2020 1:45 PM
Contacts	Authorizing Official	Update	Change Request	Adams, Jason Matthew President & COO Saint Jospeh Health 7027384546	Taylor, Lonnie Ralph VP Patient Care Services/Operations CHI Saint Joseph's Hospital East 8599675758	7/16/2020 8:11 AM
Contacts	Primary Contact	Update	Change Request	DeLuca, Michael David Manager of Pharmacy Services Saint Joseph East 8599675576	Pearcy, Ryan 340B Division Manager Catholic Health Initiatives 8592295654	3/9/2020 2:34 PM
Contacts	Authorizing Official	Update	AO Change Request	Gilliam, Eric President Saint Joseph Berea 8599675750	Adams, Jason Matthew President & COO Saint Jospeh Health 7027384546	11/7/2019 9:03 AM
Details	Last Recertification Date	Update	Recertification		8/28/2019 11:04:58 AM	8/28/2019 11:04 AM
Addresses	Billing Address	Insert	Change Request		Saint Joseph East 150 N Eagle Creek Dr Lexington, KY 40509	6/19/2019 7:57 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/13/2018 1:20 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		01022557	12/13/2018 1:20 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		KY	12/13/2018 1:20 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1447457775	12/13/2018 1:20 PM
Details	State	Update		Approved	Active	10/1/2018 12:05 AM
Contacts	Signed By	Insert	New Registration		Gilliam, Eric President Saint Joseph Berea 8599675750	7/11/2018 12:41 PM
Details	340B ID	Update	New Registration		DSH180143H	7/11/2018 12:41 PM
Details	Entity Subname	Update	New Registration	Breast Care Center	Breast Care Center - Diagnostic Mamography Services	7/11/2018 12:41 PM
Dates	Participating Approval Date	Update	New Registration		7/11/2018 12:41:45 PM	7/11/2018 12:41 PM
Details	State	Update	New Registration	Pending	Approved	7/11/2018 12:41 PM
Dates	Signed By Date	Update	New Registration		7/6/2018 7:55:04 AM	7/11/2018 12:41 PM
Dates	Start Date	Update	New Registration		10/1/2018 12:00:00 AM	7/11/2018 12:41 PM
Addresses	Main Address	Insert	New Registration		160 N Eagle Creek Drive 101 Lexington, KY 40509	7/2/2018 2:38 PM
Contacts	Authorizing Official	Insert	New Registration		Gilliam, Eric President Saint Joseph Berea 8599675750	7/2/2018 2:38 PM
Contacts	Primary Contact	Insert	New Registration		DeLuca, Michael David Manager of Pharmacy Services Saint Joseph East 8599675576	7/2/2018 2:38 PM
Details	Last Recertification Date	Insert	New Registration			7/2/2018 2:38 PM
Details	Grant Number	Insert	New Registration			7/2/2018 2:38 PM
Details	340B ID	Insert	New Registration			7/2/2018 2:38 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/2/2018 2:38 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/2/2018 2:38 PM
Details	Medicare Provider Number	Insert	New Registration		180143	7/2/2018 2:38 PM
Details	Entity Name	Insert	New Registration		SAINT JOSEPH EAST	7/2/2018 2:38 PM
Details	Program Code	Insert	New Registration		DSH	7/2/2018 2:38 PM
Details	Entity Subname	Insert	New Registration		Breast Care Center	7/2/2018 2:38 PM
Dates	Participating Approval Date	Insert	New Registration			7/2/2018 2:38 PM
Details	State	Insert	New Registration		Pending	7/2/2018 2:38 PM
Dates	Registration Date	Insert	New Registration		7/2/2018 2:38:34 PM	7/2/2018 2:38 PM
Dates	Signed By Date	Insert	New Registration			7/2/2018 2:38 PM
Dates	Start Date	Insert	New Registration			7/2/2018 2:38 PM
Terminations	Termination Comments	Insert	New Registration			7/2/2018 2:38 PM
Terminations	Termination Date	Insert	New Registration			7/2/2018 2:38 PM
Terminations	Termination Effective Date	Insert	New Registration			7/2/2018 2:38 PM
Terminations	Termination Reason	Insert	New Registration			7/2/2018 2:38 PM