Covered Entity Details

DSH260183G SAINT FRANCIS MEDICAL CENTER (Active) - information as of 4/29/2025 1:40:40 AM

Main Details

Name

SAINT FRANCIS MEDICAL CENTER

Subdivision Name

CAPE PHYSICIAN ASSOCIATES - Pediatrics

Type

Disproportionate Share Hospital

Rural

340B ID

DSH260183G

Medicare Provider Number

260183

Outpatient Facility Provider Number

050024

Additional Details

Current Program Status

Active

Registration Date

10/10/2018

Participating Start Date

1/1/2019

Participating Approval Date

10/25/2018

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

3250 GORDONVILLE RD STE 301
CAPE GIRARDEAU, MO 63703-5095

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?
No

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
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
Addresses	Main Address	Update	Change Request	3250 GORDONVILLE RD STE 301 CAPE GIRARDEAU, MO 63703-5095	3250 GORDONVILLE RD STE 301 CAPE GIRARDEAU, MO 63703-5095	4/8/2025 1:23 PM
Details	Entity Subname	Update	Change Request	CAPE PHYSICIAN ASSOCIATES - Primary Care	CAPE PHYSICIAN ASSOCIATES - Pediatrics	4/8/2025 1:23 PM
Details	Last Recertification Date	Update	Recertification	8/24/2023 2:22:59 PM	8/29/2024 9:39:02 AM	8/29/2024 9:39 AM
Details	Last Recertification Date	Update	Recertification	9/7/2022 12:45:35 PM	8/24/2023 2:22:59 PM	8/24/2023 2:22 PM
Details	Last Recertification Date	Update	Recertification	9/2/2021 4:31:13 PM	9/7/2022 12:45:35 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 12:19:43 PM	9/2/2021 4:31:13 PM	9/2/2021 4:31 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1578513016 (MO)		9/8/2020 12:19 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1578513016 ( )		9/8/2020 12:19 PM
Details	Last Recertification Date	Update	Recertification	9/8/2019 2:22:59 PM	9/8/2020 12:19:43 PM	9/8/2020 12:19 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		9/8/2019 2:22:59 PM	9/8/2019 2:22 PM
Details	State	Update		Approved	Active	1/1/2019 12:05 AM
Contacts	Signed By	Insert	New Registration		REESE, MARYANN PRESIDENT AND CEO Saint Francis Medical Center 5733313532	10/25/2018 10:13 AM
Details	340B ID	Update	New Registration		DSH260183G	10/25/2018 10:13 AM
Details	Entity Subname	Update	New Registration	CAPE PHYSICIAN ASSOCIATES	CAPE PHYSICIAN ASSOCIATES - Primary Care	10/25/2018 10:13 AM
Dates	Participating Approval Date	Update	New Registration		10/25/2018 10:13:52 AM	10/25/2018 10:13 AM
Details	State	Update	New Registration	Pending	Approved	10/25/2018 10:13 AM
Dates	Signed By Date	Update	New Registration		10/11/2018 7:38:11 AM	10/25/2018 10:13 AM
Dates	Start Date	Update	New Registration		1/1/2019 12:00:00 AM	10/25/2018 10:13 AM
Addresses	Main Address	Insert	New Registration		3250 GORDONVILLE RD STE 301 CAPE GIRARDEAU, MO 63703-5095	10/10/2018 1:53 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/10/2018 1:53 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1578513016	10/10/2018 1:53 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		MO	10/10/2018 1:53 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1578513016	10/10/2018 1:53 PM
Contacts	Authorizing Official	Insert	New Registration		REESE, MARYANN PRESIDENT AND CEO Saint Francis Medical Center 5733313532	10/10/2018 1:53 PM
Contacts	Primary Contact	Insert	New Registration		YOUNT, WILLIAM GRADY DIRECTOR OF PHARMACY Saint Francis Medical Center 5733315251	10/10/2018 1:53 PM
Details	Last Recertification Date	Insert	New Registration			10/10/2018 1:53 PM
Details	Grant Number	Insert	New Registration			10/10/2018 1:53 PM
Details	340B ID	Insert	New Registration			10/10/2018 1:53 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/10/2018 1:53 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/10/2018 1:53 PM
Details	Medicare Provider Number	Insert	New Registration		260183	10/10/2018 1:53 PM
Details	Entity Name	Insert	New Registration		SAINT FRANCIS MEDICAL CENTER	10/10/2018 1:53 PM
Details	Program Code	Insert	New Registration		DSH	10/10/2018 1:53 PM
Details	Entity Subname	Insert	New Registration		CAPE PHYSICIAN ASSOCIATES	10/10/2018 1:53 PM
Dates	Participating Approval Date	Insert	New Registration			10/10/2018 1:53 PM
Details	State	Insert	New Registration		Pending	10/10/2018 1:53 PM
Dates	Registration Date	Insert	New Registration		10/10/2018 1:53:16 PM	10/10/2018 1:53 PM
Dates	Signed By Date	Insert	New Registration			10/10/2018 1:53 PM
Dates	Start Date	Insert	New Registration			10/10/2018 1:53 PM
Terminations	Termination Comments	Insert	New Registration			10/10/2018 1:53 PM
Terminations	Termination Date	Insert	New Registration			10/10/2018 1:53 PM
Terminations	Termination Effective Date	Insert	New Registration			10/10/2018 1:53 PM
Terminations	Termination Reason	Insert	New Registration			10/10/2018 1:53 PM