340B Drug Pricing Program Database


DSH260023C MERCY HOSPITAL JEFFERSON (Active) - information as of 4/25/2025 5:41:04 PM

Main Details
MERCY HOSPITAL JEFFERSON
MERCY SURGERY CENTER - SHU PRE/POST PACU
Disproportionate Share Hospital
No
DSH260023C
260023


Additional Details
Active
10/5/2022
11/3/2022
10/19/2022
8/21/2024

Contacts

Mercy
Scott Martinez, Executive Director Finance
(636) 933-1102

Mercy Shared Services
Mike Loftus, Director-Hospital Pharmacy
(417) 820-3487

Addresses

1377 HIGHWAY 61 S
FESTUS, MO 63028-4107

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
MO0101557031508859661
Shipping Addresses

Same as Street Address
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH260023AChildDSHMERCY HOSPITAL JEFFERSONCANCER CENTER - Radiation Therapy1350 US HIGHWAY 61FESTUSMOActive
DSH260023BChildDSHMERCY HOSPITAL JEFFERSONMERCY SURGERY CENTER - SHU Endoscopy1377 HIGHWAY 61 SFESTUSMOActive
DSH260023CChildDSHMERCY HOSPITAL JEFFERSONMERCY SURGERY CENTER - SHU PRE/POST PACU1377 HIGHWAY 61 SFESTUSMOActive
DSH260023DChildDSHMERCY HOSPITAL JEFFERSONMERCY IMAGING SERVICES - Offsite Radiology1500 CALVARY CHURCH RDFESTUSMOActive
DSH260023EChildDSHMERCY HOSPITAL JEFFERSONMERCY SURGERY CENTER - SHU Operating Room1377 HIGHWAY 61 SFESTUSMOActive
DSH260023FChildDSHMERCY HOSPITAL JEFFERSONMERCY HOSPITAL JEFFERSON - Jefferson - Infusion Center1350 US HIGHWAY 61FESTUSMOActive
DSH260023GChildDSHMERCY HOSPITAL JEFFERSONCANCER CENTER - Oncology and Hematology Cancer Center1350 US HIGHWAY 61FESTUSMOActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
Medicaid BillingNPI: NumberDeleteRecertification1386823631 (MO) 8/21/2024 11:02 AM
ContactsPrimary ContactUpdateRecertificationLoftus, Mike Director-Pharmacy Services Mercy 4178203487Loftus, Mike Director-Hospital Pharmacy Mercy Shared Services 41782034878/21/2024 11:02 AM
DetailsLast Recertification DateUpdateRecertification8/15/2023 4:28:09 PM8/21/2024 11:02:34 AM8/21/2024 11:02 AM
ContactsAuthorizing OfficialUpdateChange RequestEckenfels, Daniel S Comunity President Mercy 6369331107Martinez, Scott Executive Director Finance Mercy 63693311027/9/2024 7:32 AM
ContactsAuthorizing OfficialUpdateProfile Change RequestEckenfels, Daniel S Vice President - Finance Mercy 3145251483Eckenfels, Daniel S Comunity President Mercy 63693311074/12/2024 12:48 PM
ContactsSigned ByUpdateProfile Change RequestEckenfels, Daniel S Vice President - Finance Mercy 3145251483Eckenfels, Daniel S Comunity President Mercy 63693311074/12/2024 12:48 PM
DetailsLast Recertification DateUpdateRecertification 8/15/2023 4:28:09 PM8/15/2023 4:28 PM
DetailsStateUpdateOPA EditApprovedActive11/3/2022 1:53 PM
DatesStart DateUpdateOPA Edit1/1/2023 12:00:00 AM11/3/2022 12:00:00 AM11/3/2022 1:53 PM
ContactsSigned ByInsertNew Registration Eckenfels, Daniel S Vice President - Finance Mercy 314525148310/19/2022 11:14 AM
Details340B IDUpdateNew Registration DSH260023C10/19/2022 11:14 AM
DetailsEntity SubnameUpdateNew RegistrationMERCY SURGERY CENTERMERCY SURGERY CENTER - SHU PRE/POST PACU10/19/2022 11:14 AM
DatesParticipating Approval DateUpdateNew Registration 10/19/2022 11:14:07 AM10/19/2022 11:14 AM
DetailsStateUpdateNew RegistrationPendingApproved10/19/2022 11:14 AM
DatesSigned By DateUpdateNew Registration 10/12/2022 11:04:28 AM10/19/2022 11:14 AM
DatesStart DateUpdateNew Registration 1/1/2023 12:00:00 AM10/19/2022 11:14 AM
AddressesMain AddressInsertNew Registration  1377 HIGHWAY 61 S FESTUS, MO 63028-410710/5/2022 2:21 PM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False10/5/2022 2:21 PM
Medicaid BillingMedicaid: NumberInsertNew Registration 01015570310/5/2022 2:21 PM
Medicaid BillingMedicaid: StateInsertNew Registration MO10/5/2022 2:21 PM
Medicaid BillingNPI: NumberInsertNew Registration 150885966110/5/2022 2:21 PM
Medicaid BillingNPI: StateInsertNew Registration MO10/5/2022 2:21 PM
Medicaid BillingNPI: NumberInsertNew Registration 138682363110/5/2022 2:21 PM
Medicaid BillingNPI: StateInsertNew Registration MO10/5/2022 2:21 PM
ContactsPrimary ContactInsertNew Registration Loftus, Mike Director-Pharmacy Services Mercy 417820348710/5/2022 2:21 PM
ContactsAuthorizing OfficialInsertNew Registration Eckenfels, Daniel S Vice President - Finance Mercy 314525148310/5/2022 2:21 PM
DetailsAssistance Received From DateInsertNew Registration  10/5/2022 2:21 PM
DetailsAssistance Received To DateInsertNew Registration  10/5/2022 2:21 PM
DetailsLast Recertification DateInsertNew Registration  10/5/2022 2:21 PM
DetailsGrant NumberInsertNew Registration  10/5/2022 2:21 PM
Details340B IDInsertNew Registration  10/5/2022 2:21 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  10/5/2022 2:21 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  10/5/2022 2:21 PM
DetailsMedicare Provider NumberInsertNew Registration 26002310/5/2022 2:21 PM
DetailsEntity NameInsertNew Registration MERCY HOSPITAL JEFFERSON10/5/2022 2:21 PM
DetailsNOFO NumberInsertNew Registration  10/5/2022 2:21 PM
DetailsProgram CodeInsertNew Registration DSH10/5/2022 2:21 PM
DetailsEntity SubnameInsertNew Registration MERCY SURGERY CENTER10/5/2022 2:21 PM
DatesParticipating Approval DateInsertNew Registration  10/5/2022 2:21 PM
DetailsStateInsertNew Registration Pending10/5/2022 2:21 PM
DatesRegistration DateInsertNew Registration 10/5/2022 2:21:15 PM10/5/2022 2:21 PM
DatesSigned By DateInsertNew Registration  10/5/2022 2:21 PM
DatesStart DateInsertNew Registration  10/5/2022 2:21 PM
TerminationsTermination CommentsInsertNew Registration  10/5/2022 2:21 PM
TerminationsTermination DateInsertNew Registration  10/5/2022 2:21 PM
TerminationsTermination Effective DateInsertNew Registration  10/5/2022 2:21 PM
TerminationsTermination ReasonInsertNew Registration  10/5/2022 2:21 PM