340B Drug Pricing Program Database


DSH140029P COPLEY MEMORIAL HOSPITAL (Active) - information as of 6/8/2025 1:03:47 AM

Main Details
COPLEY MEMORIAL HOSPITAL
PULMONOLOGY - HIGHLAND - Pulmonary Highland
Disproportionate Share Hospital
No
DSH140029P
140029


Additional Details
Active
4/15/2022
7/1/2022
4/21/2022
8/29/2024

Contacts

Rush University System for Health
Kate Marie Schaafsma, VP, Chief Pharmacy Officer
(815) 592-4299

Copley Memorial Hospital
Stacey Ries, Deputy General Counsel
(630) 499-4721

Addresses

1320 N HIGHLAND AVE
STE A
AURORA, IL 60506-1468

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
IL36217084040411295882561,1619466034
Shipping Addresses

Same as Street Address
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH140029AChildDSHCOPLEY MEMORIAL HOSPITALRUSH-COPLEY HEART INSTITUTE2088 OGDEN AVEAURORAILActive
DSH140029BChildDSHCOPLEY MEMORIAL HOSPITALRUSH COPLEY CANCER CARE CLINIC YORK1100W VETERANS PKWYYORKVILLEILActive
DSH140029CChildDSHCOPLEY MEMORIAL HOSPITALRUSH-COPLEY EMERGENCY CENTER - YOR1122W VETERANS PKWYYORKVILLEILActive
DSH140029DChildDSHCOPLEY MEMORIAL HOSPITALENDOCRINOLOGY - Endocrinology2040 OGDEN AVEAURORAILActive
DSH140029EChildDSHCOPLEY MEMORIAL HOSPITALCOPLEY MEMORIAL HOSPITAL INC - Residency Family Medicine2020 OGDEN AVE SUITE 330AURORAILActive
DSH140029FChildDSHCOPLEY MEMORIAL HOSPITALDIGESTIVE DISEASE - WATERFORD - GI Waterford2040 Ogden AvenueAURORAILActive
DSH140029GChildDSHCOPLEY MEMORIAL HOSPITALCARDIOVASCULAR - HIGHLAND - CV - Highland1320 N HIGHLAND AVEAURORAILActive
DSH140029HChildDSHCOPLEY MEMORIAL HOSPITALCARDIOVASCULAR - 2088 - CV - Ogden2088 OGDEN AVEAURORAILActive
DSH140029JChildDSHCOPLEY MEMORIAL HOSPITALRADIATION ONCOLOGY - Radiation Oncology2000 OGDEN AVEAURORAILActive
DSH140029KChildDSHCOPLEY MEMORIAL HOSPITALCARDIOVASCULAR - YORKVILLE - CV - Yorkville1100 W VETERANS PKWYYORKVILLEILActive
DSH140029LChildDSHCOPLEY MEMORIAL HOSPITALONCOLOGY - OGDEN - oncology Ogden2000 OGDEN AVEAURORAILActive
DSH140029MChildDSHCOPLEY MEMORIAL HOSPITALONCOLOGY YORKVILLE - oncology Yorkville1100 W VETERANS PKWYYORKVILLEILActive
DSH140029NChildDSHCOPLEY MEMORIAL HOSPITALPULMONARY - 2088 - Pulmonary Ogden2040 Ogden AvenueAURORAILActive
DSH140029PChildDSHCOPLEY MEMORIAL HOSPITALPULMONOLOGY - HIGHLAND - Pulmonary Highland1320 N HIGHLAND AVEAURORAILActive
DSH140029QChildDSHCOPLEY MEMORIAL HOSPITALENT - ENt2040 Ogden AvenueAuroraILActive
DSH140029RChildDSHCOPLEY MEMORIAL HOSPITALUrology - Urology2040 Ogden AvenueAuroraILActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsAuthorizing OfficialUpdateAO Change RequestVanWyhe, Brenda SENIOR VP FINANCE AND CFO Copley Memorial Hospital 6308983565Schaafsma, Kate Marie VP, Chief Pharmacy Officer Rush University System for Health 81559242995/15/2025 6:10 AM
DetailsLast Recertification DateUpdateRecertification8/29/2023 10:54:12 AM8/29/2024 9:56:05 AM8/29/2024 9:56 AM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False8/29/2023 10:54 AM
Medicaid BillingMedicaid: NumberInsertRecertification 36217084040418/29/2023 10:54 AM
Medicaid BillingMedicaid: StateInsertRecertification IL8/29/2023 10:54 AM
Medicaid BillingNPI: NumberInsertRecertification 12958825618/29/2023 10:54 AM
Medicaid BillingNPI: StateInsertRecertification IL8/29/2023 10:54 AM
Medicaid BillingNPI: NumberInsertRecertification 16194660348/29/2023 10:54 AM
Medicaid BillingNPI: StateInsertRecertification IL8/29/2023 10:54 AM
DetailsLast Recertification DateUpdateRecertification8/24/2022 3:34:58 PM8/29/2023 10:54:12 AM8/29/2023 10:54 AM
DetailsLast Recertification DateUpdateRecertification 8/24/2022 3:34:58 PM8/24/2022 3:34 PM
DetailsStateUpdate ApprovedActive7/1/2022 12:01 AM
ContactsSigned ByInsertNew Registration VanWyhe, Brenda SENIOR VP FINANCE AND CFO Copley Memorial Hospital 63089835654/21/2022 3:31 PM
Details340B IDUpdateNew Registration DSH140029P4/21/2022 3:31 PM
DetailsEntity SubnameUpdateNew RegistrationPULMONOLOGY - HIGHLANDPULMONOLOGY - HIGHLAND - Pulmonary Highland4/21/2022 3:31 PM
DatesParticipating Approval DateUpdateNew Registration 4/21/2022 3:31:09 PM4/21/2022 3:31 PM
DetailsStateUpdateNew RegistrationPendingApproved4/21/2022 3:31 PM
DatesSigned By DateUpdateNew Registration 4/19/2022 5:40:23 PM4/21/2022 3:31 PM
DatesStart DateUpdateNew Registration 7/1/2022 12:00:00 AM4/21/2022 3:31 PM
AddressesMain AddressInsertNew Registration  1320 N HIGHLAND AVE STE A AURORA, IL 60506-14684/15/2022 12:48 PM
ContactsPrimary ContactInsertNew Registration Ries, Stacey Deputy General Counsel Copley Memorial Hospital 63049947214/15/2022 12:48 PM
ContactsAuthorizing OfficialInsertNew Registration VanWyhe, Brenda SENIOR VP FINANCE AND CFO Copley Memorial Hospital 63089835654/15/2022 12:48 PM
DetailsAssistance Received From DateInsertNew Registration  4/15/2022 12:48 PM
DetailsAssistance Received To DateInsertNew Registration  4/15/2022 12:48 PM
DetailsLast Recertification DateInsertNew Registration  4/15/2022 12:48 PM
DetailsGrant NumberInsertNew Registration  4/15/2022 12:48 PM
Details340B IDInsertNew Registration  4/15/2022 12:48 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  4/15/2022 12:48 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  4/15/2022 12:48 PM
DetailsMedicare Provider NumberInsertNew Registration 1400294/15/2022 12:48 PM
DetailsEntity NameInsertNew Registration COPLEY MEMORIAL HOSPITAL4/15/2022 12:48 PM
DetailsNOFO NumberInsertNew Registration  4/15/2022 12:48 PM
DetailsProgram CodeInsertNew Registration DSH4/15/2022 12:48 PM
DetailsEntity SubnameInsertNew Registration PULMONOLOGY - HIGHLAND4/15/2022 12:48 PM
DatesParticipating Approval DateInsertNew Registration  4/15/2022 12:48 PM
DetailsStateInsertNew Registration Pending4/15/2022 12:48 PM
DatesRegistration DateInsertNew Registration 4/15/2022 12:48:23 PM4/15/2022 12:48 PM
DatesSigned By DateInsertNew Registration  4/15/2022 12:48 PM
DatesStart DateInsertNew Registration  4/15/2022 12:48 PM
TerminationsTermination CommentsInsertNew Registration  4/15/2022 12:48 PM
TerminationsTermination DateInsertNew Registration  4/15/2022 12:48 PM
TerminationsTermination Effective DateInsertNew Registration  4/15/2022 12:48 PM
TerminationsTermination ReasonInsertNew Registration  4/15/2022 12:48 PM