Covered Entity Details

DSH390049U ST. LUKES HOSPITAL (Active) - information as of 5/1/2025 11:53:29 PM

Main Details

Name

ST. LUKES HOSPITAL

Subdivision Name

Sacred Heart Campus - Operating Room

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH390049U

Medicare Provider Number

390049

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/13/2021

Participating Start Date

1/1/2022

Participating Approval Date

11/16/2021

Last Recertification Date

8/21/2024

Contacts

Authorizing Official

St. Luke's Hospital
Elizabeth Artis, Finance Director
(484) 526-4707

Primary Contact

St Luke's University Health Network
Steven J Frankenbach, Senior Director, Network Reimbursement
(484) 526-3093

Addresses

Street Address

421 Chew Street
Allentown, PA 18102

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
PA	1007457000001,100745710051,1007552510117	1548293954,1952399933,1013933175,1538237722,1255579223,1629109525,1073543120,1366011413

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
DSH390049A	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Infusion	211 North 12th Street	Lehighton	PA	Active
DSH390049AA	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Nuclear Medicine	211 North 12th Street	Lehighton	PA	Terminated
DSH390049AB	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Radiology Diagnostic	211 North 12th Street	Lehighton	PA	Terminated
DSH390049AC	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Wound Care	211 North 12th Street	Lehighton	PA	Terminated
DSH390049AD	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Anesthesiology	211 North 12th Street	Lehighton	PA	Terminated
DSH390049AE	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - CT Scan	211 North 12th Street	Lehighton	PA	Terminated
DSH390049AF	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Cardiology-EKG	211 North 12th Street	Lehighton	PA	Terminated
DSH390049AG	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Operating Room	211 North 12th Street	Lehighton	PA	Terminated
DSH390049AH	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - CT Scan	421 Chew Street	Allentown	PA	Active
DSH390049AJ	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Interventional Radiology Unit	1736 Hamilton Street	Allentown	PA	Active
DSH390049AK	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Dialysis	421 Chew Street	Allentown	PA	Active
DSH390049AL	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Radiology Ultrasound	1736 Hamilton Street	Allentown	PA	Active
DSH390049AM	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Radiology CT Scan	1736 Hamilton Street	Allentown	PA	Active
DSH390049AN	Child	DSH	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - Hamburg Care Now	9 DAVES WAY	HAMBURG	PA	Active
DSH390049AP	Child	DSH	ST. LUKES HOSPITAL	ST LUKES HOSPITAL - Allentown Campus-Pain Management Center	501 CETRONIA ROAD	ALLENTOWN	PA	Active
DSH390049AQ	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Emergency Care Unit	1736 Hamilton Street	Allentown	PA	Active
DSH390049AR	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Cardiology-EKG	421 Chew Street	Allentown	PA	Active
DSH390049AS	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - EKG and Diagnostic Cardiology	1736 Hamilton Street	Allentown	PA	Active
DSH390049AT	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Vascular Lab	211 North 12th Street	Lehighton	PA	Terminated
DSH390049AU	Child	DSH	ST. LUKES HOSPITAL	ST. LUKE'S HOSPITAL BETHLEHEM - Bethlehem Campus- Radiology Pet Scanner	153 BRODHEAD RD	BETHLEHEM	PA	Active
DSH390049AV	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Post Acute Anesthesia Care Unit	1736 Hamilton Street	Allentown	PA	Active
DSH390049AW	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Respiratory Therapy	421 Chew Street	Allentown	PA	Active
DSH390049AX	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Ultrasound	211 North 12th Street	Lehighton	PA	Terminated
DSH390049AY	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Lanshe Breast Center	421 Chew Street	Allentown	PA	Active
DSH390049AZ	Child	DSH	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - Allentown Campus-Whitehall Care Now	2402 MACARTHUR RD.	WHITEHALL	PA	Active
DSH390049B	Child	DSH	ST. LUKES HOSPITAL	ST. LUKE'S HOSPITAL BETHLEHEM - Allentown Campus-Cancer Center Suite 100N	240 CETRONIA RD	ALLENTOWN	PA	Active
DSH390049BA	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Pet Scanner	421 Chew Street	Allentown	PA	Active
DSH390049BB	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Cath Lab Unit	1736 Hamilton Street	Allentown	PA	Active
DSH390049BC	Child	DSH	ST. LUKES HOSPITAL	ST. LUKE'S HOSPITAL BETHLEHEM - Bethlehem Campus-Pain Management Center	830 OSTRUM ST	BETHLEHEM	PA	Active
DSH390049BD	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Radiology Diagnostic	1736 Hamilton Street	Allentown	PA	Active
DSH390049BE	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Operating Room	1736 Hamilton Street	Allentown	PA	Active
DSH390049BF	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Neurodiagnostic	421 Chew Street	Allentown	PA	Active
DSH390049BG	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Emergency Department	211 North 12th Street	Lehighton	PA	Terminated
DSH390049BH	Child	DSH	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - Allentown Campus- Urgent Care West End	501 CENTRONIA ROAD	ALLENTOWN	PA	Active
DSH390049BJ	Child	DSH	ST. LUKES HOSPITAL	ST LUKES HOSPITAL - Allentown Campus-West End Endoscopy	501 CETRONIA ROAD	ALLENTOWN	PA	Active
DSH390049BK	Child	DSH	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - SH Imaging-Northampton	602B E 21ST ST	NORTHAMPTON	PA	Active
DSH390049BL	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Nuclear Medicine	421 Chew Street	Allentown	PA	Active
DSH390049BM	Child	DSH	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - Bethlehem Campus- Urgent Care	153 BRODHEAD RD	BETHLEHEM	PA	Active
DSH390049BN	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Ambulatory Procedure Unit	1736 Hamilton Street	Allentown	PA	Active
DSH390049BP	Child	DSH	ST. LUKES HOSPITAL	ST. LUKE'S HOSPITAL BETHLEHEM - Bethlehem Campus-Heart and Vascular	1469 8TH AVE	BETHLEHEM	PA	Active
DSH390049BQ	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Anesthesiology	1736 Hamilton Street	Allentown	PA	Active
DSH390049BR	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Anesthesiology	421 Chew Street	Allentown	PA	Active
DSH390049BS	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Respiratory Therapy	1736 Hamilton Street	Allentown	PA	Active
DSH390049BT	Child	DSH	ST. LUKES HOSPITAL	Bethlehem Campus - Center Valley Care Now	5445 Lanark Road	Center Valley	PA	Active
DSH390049BU	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Wound Care	421 Chew Street	Allentown	PA	Active
DSH390049BV	Child	DSH	ST. LUKES HOSPITAL	ST. LUKE'S HOSPITAL - St Lukes Hospital Bethlehem-SL Care Now Kutztown	15065 KUTZTOWN RD	KUTZTOWN	PA	Active
DSH390049BW	Child	DSH	ST. LUKES HOSPITAL	West End Ortho - Radiology Diagnostic	521 Cetronia Rd	Allentown	PA	Active
DSH390049BX	Child	DSH	ST. LUKES HOSPITAL	West End Ortho - Operating Room	521 Cetronia Rd	Allentown	PA	Active
DSH390049BY	Child	DSH	ST. LUKES HOSPITAL	West End Ortho - APU-PACU	521 Cetronia Rd	Allentown	PA	Active
DSH390049BZ	Child	DSH	ST. LUKES HOSPITAL	Allentown - Care Now Spring Township	2701 Shillington Rd	Spring Township	PA	Approved
DSH390049C	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Endoscopy Unit	1736 Hamilton Street	Allentown	PA	Active
DSH390049D	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Endoscopy Unit	421 Chew Street	Allentown	PA	Active
DSH390049E	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Interventional Radiology Unit	421 Chew Street	Allentown	PA	Active
DSH390049F	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Ambulatory Procedure Unit	421 Chew Street	Allentown	PA	Active
DSH390049G	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Emergency Department	421 Chew Street	Allentown	PA	Active
DSH390049H	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Ultrasound	421 Chew Street	Allentown	PA	Active
DSH390049J	Child	DSH	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - Care Now Forks	2003 SULLIVAN TRAIL	EASTON	PA	Active
DSH390049K	Child	DSH	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - Care Now Jim Thorpe	1104 NORTH ST	JIM THORPE	PA	Active
DSH390049L	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Radiology Interventional	211 North 12th Street	Lehighton	PA	Terminated
DSH390049M	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Pain Management	211 North 12th Street	Lehighton	PA	Terminated
DSH390049N	Child	DSH	ST. LUKES HOSPITAL	Allentown Campus - Labor and Delivery Unit	1736 Hamilton Street	Allentown	PA	Active
DSH390049P	Child	DSH	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - Care Now Macungie	2550 ROUTE 100 STE 110	MACUNGIE	PA	Active
DSH390049Q	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - PACU	421 Chew Street	Allentown	PA	Active
DSH390049R	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - PACU	211 North 12th Street	Lehighton	PA	Terminated
DSH390049S	Child	DSH	ST. LUKES HOSPITAL	ST. LUKE'S HOSPITAL BETHLEHEM - Allentown Campus- Radiation Oncology	240 CETRONIA RD	ALLENTOWN	PA	Active
DSH390049T	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Respiratory Therapy	211 North 12th Street	Lehighton	PA	Terminated
DSH390049U	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Operating Room	421 Chew Street	Allentown	PA	Active
DSH390049V	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Infusion	421 Chew Street	Allentown	PA	Active
DSH390049W	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - MRI	211 North 12th Street	Lehighton	PA	Terminated
DSH390049X	Child	DSH	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Ambulatory Procedure Unit	211 North 12th Street	Lehighton	PA	Terminated
DSH390049Y	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - Vascular Lab	421 Chew Street	Allentown	PA	Active
DSH390049Z	Child	DSH	ST. LUKES HOSPITAL	Sacred Heart Campus - MRI Center	421 Chew Street	Allentown	PA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	9/6/2023 9:27:18 AM	8/21/2024 11:06:24 AM	8/21/2024 11:06 AM
Details	Last Recertification Date	Update	Recertification	9/15/2022 1:35:09 PM	9/6/2023 9:27:18 AM	9/6/2023 9:27 AM
Details	Last Recertification Date	Update	Recertification		9/15/2022 1:35:09 PM	9/15/2022 1:35 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	4/13/2022 1:45 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1007552510117	4/13/2022 1:45 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		PA	4/13/2022 1:45 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1366011413	4/13/2022 1:45 PM
Medicaid Billing	NPI: State	Insert	Change Request		PA	4/13/2022 1:45 PM
Details	State	Update		Approved	Active	1/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		Artis, Elizabeth Finance Director St. Luke's Hospital 4845264707	11/16/2021 8:22 AM
Details	340B ID	Update	New Registration		DSH390049U	11/16/2021 8:22 AM
Details	Entity Subname	Update	New Registration	Sacred Heart Campus	Sacred Heart Campus - Operating Room	11/16/2021 8:22 AM
Dates	Participating Approval Date	Update	New Registration		11/16/2021 8:22:48 AM	11/16/2021 8:22 AM
Details	State	Update	New Registration	Pending	Approved	11/16/2021 8:22 AM
Dates	Signed By Date	Update	New Registration		11/15/2021 8:35:57 AM	11/16/2021 8:22 AM
Dates	Start Date	Update	New Registration		1/1/2022 12:00:00 AM	11/16/2021 8:22 AM
Addresses	Main Address	Insert	New Registration		421 Chew Street Allentown, PA 18102	10/13/2021 6:20 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/13/2021 6:20 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1007457000001	10/13/2021 6:20 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		PA	10/13/2021 6:20 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/13/2021 6:20 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		100745710051	10/13/2021 6:20 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		PA	10/13/2021 6:20 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1548293954	10/13/2021 6:20 PM
Medicaid Billing	NPI: State	Insert	New Registration		PA	10/13/2021 6:20 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1952399933	10/13/2021 6:20 PM
Medicaid Billing	NPI: State	Insert	New Registration		PA	10/13/2021 6:20 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1013933175	10/13/2021 6:20 PM
Medicaid Billing	NPI: State	Insert	New Registration		PA	10/13/2021 6:20 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1538237722	10/13/2021 6:20 PM
Medicaid Billing	NPI: State	Insert	New Registration		PA	10/13/2021 6:20 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1255579223	10/13/2021 6:20 PM
Medicaid Billing	NPI: State	Insert	New Registration		PA	10/13/2021 6:20 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1629109525	10/13/2021 6:20 PM
Medicaid Billing	NPI: State	Insert	New Registration		PA	10/13/2021 6:20 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1073543120	10/13/2021 6:20 PM
Medicaid Billing	NPI: State	Insert	New Registration		PA	10/13/2021 6:20 PM
Contacts	Primary Contact	Insert	New Registration		Frankenbach, Steven J Senior Director, Network Reimbursement St Luke's University Health Network 4845263093	10/13/2021 6:20 PM
Contacts	Authorizing Official	Insert	New Registration		Artis, Elizabeth Finance Director St. Luke's Hospital 4845264707	10/13/2021 6:20 PM
Details	Assistance Received From Date	Insert	New Registration			10/13/2021 6:20 PM
Details	Assistance Received To Date	Insert	New Registration			10/13/2021 6:20 PM
Details	Last Recertification Date	Insert	New Registration			10/13/2021 6:20 PM
Details	Grant Number	Insert	New Registration			10/13/2021 6:20 PM
Details	340B ID	Insert	New Registration			10/13/2021 6:20 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/13/2021 6:20 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/13/2021 6:20 PM
Details	Medicare Provider Number	Insert	New Registration		390049	10/13/2021 6:20 PM
Details	Entity Name	Insert	New Registration		ST. LUKES HOSPITAL	10/13/2021 6:20 PM
Details	NOFO Number	Insert	New Registration			10/13/2021 6:20 PM
Details	Program Code	Insert	New Registration		DSH	10/13/2021 6:20 PM
Details	Entity Subname	Insert	New Registration		Sacred Heart Campus	10/13/2021 6:20 PM
Dates	Participating Approval Date	Insert	New Registration			10/13/2021 6:20 PM
Details	State	Insert	New Registration		Pending	10/13/2021 6:20 PM
Dates	Registration Date	Insert	New Registration		10/13/2021 6:20:47 PM	10/13/2021 6:20 PM
Dates	Signed By Date	Insert	New Registration			10/13/2021 6:20 PM
Dates	Start Date	Insert	New Registration			10/13/2021 6:20 PM
Terminations	Termination Comments	Insert	New Registration			10/13/2021 6:20 PM
Terminations	Termination Date	Insert	New Registration			10/13/2021 6:20 PM
Terminations	Termination Effective Date	Insert	New Registration			10/13/2021 6:20 PM
Terminations	Termination Reason	Insert	New Registration			10/13/2021 6:20 PM