Covered Entity Details

DSH390326A ST LUKE HOSPITAL ANDERSON CAMPUS (Active) - information as of 6/12/2025 9:44:28 PM

Main Details

Name

ST LUKE HOSPITAL ANDERSON CAMPUS

Subdivision Name

ST LUKES HOSPITAL ANDERSON CAMPUS - Operating Room Specialty Pavilion

Type

Disproportionate Share Hospital

Rural

340B ID

DSH390326A

Medicare Provider Number

390326

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/14/2023

Participating Start Date

7/1/2023

Participating Approval Date

5/23/2023

Last Recertification Date

8/21/2024

Contacts

Authorizing Official

St. Luke's Hospital-Anderson Campus
Jennifer Singer, Finance Director
(484) 658-0925

Primary Contact

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

Addresses

Street Address

2220 ST LUKES BLVD
SUITE 230
EASTON, PA 18045

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	102809290-001,102809290-006	1497050470,1023689676,1376965731

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
DSH390326A	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - Operating Room Specialty Pavilion	2220 ST LUKES BLVD	EASTON	PA	Active
DSH390326B	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - SL Mohs Micrographic Surgery	1600 ST LUKE'S BLVD	EASTON	PA	Active
DSH390326C	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - PACU Specialty Pavilion	2220 ST LUKES BLVD	EASTON	PA	Active
DSH390326D	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	Specialty Pavilion - Anesthesiology Specialty Pavilion	2200 St. Luke's Blvd	Easton	PA	Active
DSH390326E	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	Specialty Pavilion - Radiology Diagnostic-Specialty Pavilion	2200 St. Luke's Blvd	Easton	PA	Active
DSH390326F	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - Infusion Services	1600 ST LUKE'S BLVD	EASTON	PA	Active
DSH390326G	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - Radiation Oncology	1600 ST LUKE'S BLVD	EASTON	PA	Active
DSH390326H	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - HV Center Anderson-Nuclear Medicine	1700 ST LUKE'S BLVD	EASTON	PA	Active
DSH390326J	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - Nuclear Medicine- 235 East Brown Street	235 E BROWN STREET	EAST STROUDSBURG	PA	Active
DSH390326K	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - Cardiology-Echo- 235 East Brown Street	235 E BROWN STREET	EAST STROUDSBURG	PA	Active
DSH390326L	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	Specialty Pavilion - Ambulatory Procedure Unit-Specialty Pavilion	2200 St. Luke's Blvd	Easton	PA	Active
DSH390326M	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	Specialty Pavilion - Endoscopy Specialty Pavilion	2200 St. Luke's Blvd	Easton	PA	Active
DSH390326N	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - Vascular Lab HV	1700 ST LUKE'S BLVD	EASTON	PA	Active
DSH390326P	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - Vascular Lab 235 East Brown Street	235 E BROWN STREET	EAST STROUDSBURG	PA	Active
DSH390326Q	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	Specialty Pavilion - Vascular Lab-Specialty Pavilion	2200 St. Luke's Blvd	Easton	PA	Active
DSH390326R	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - Pain Management Pocono	3 PARKINSONS ROAD	EAST STROUDSBURG	PA	Active
DSH390326S	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - Wind Gap MC Care Now	487 EAST MOORESTOWN ROAD	WIND GAP	PA	Active
DSH390326T	Child	DSH	ST LUKE HOSPITAL ANDERSON CAMPUS	Monroe - Monroe Infusion Center	200 St Luke's Lane Ste 300	Stroudsburg	PA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/22/2023 9:17:59 AM	8/21/2024 11:21:52 AM	8/21/2024 11:21 AM
Details	Last Recertification Date	Update	Recertification		8/22/2023 9:17:59 AM	8/22/2023 9:17 AM
Details	State	Update		Approved	Active	7/1/2023 12:01 AM
Contacts	Signed By	Insert	New Registration		Singer, Jennifer Finance Director St. Luke's Hospital-Anderson Campus 4846580925	5/23/2023 9:26 AM
Details	340B ID	Update	New Registration		DSH390326A	5/23/2023 9:26 AM
Details	Entity Subname	Update	New Registration	ST LUKES HOSPITAL ANDERSON CAMPUS	ST LUKES HOSPITAL ANDERSON CAMPUS - Operating Room Specialty Pavilion	5/23/2023 9:26 AM
Dates	Participating Approval Date	Update	New Registration		5/23/2023 9:26:01 AM	5/23/2023 9:26 AM
Details	State	Update	New Registration	Pending	Approved	5/23/2023 9:26 AM
Dates	Signed By Date	Update	New Registration		4/14/2023 11:23:20 AM	5/23/2023 9:26 AM
Dates	Start Date	Update	New Registration		7/1/2023 12:00:00 AM	5/23/2023 9:26 AM
Addresses	Main Address	Insert	New Registration		2220 ST LUKES BLVD SUITE 230 EASTON, PA 18045	4/14/2023 10:01 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/14/2023 10:01 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		102809290-001	4/14/2023 10:01 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		PA	4/14/2023 10:01 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/14/2023 10:01 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		102809290-006	4/14/2023 10:01 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		PA	4/14/2023 10:01 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1497050470	4/14/2023 10:01 AM
Medicaid Billing	NPI: State	Insert	New Registration		PA	4/14/2023 10:01 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1023689676	4/14/2023 10:01 AM
Medicaid Billing	NPI: State	Insert	New Registration		PA	4/14/2023 10:01 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1376965731	4/14/2023 10:01 AM
Medicaid Billing	NPI: State	Insert	New Registration		PA	4/14/2023 10:01 AM
Contacts	Primary Contact	Insert	New Registration		Frankenbach, Steven J Senior Director, Network Reimbursement St Luke's University Health Network 4845263093	4/14/2023 10:01 AM
Contacts	Authorizing Official	Insert	New Registration		Singer, Jennifer Finance Director St. Luke's Hospital-Anderson Campus 4846580925	4/14/2023 10:01 AM
Details	Assistance Received From Date	Insert	New Registration			4/14/2023 10:01 AM
Details	Assistance Received To Date	Insert	New Registration			4/14/2023 10:01 AM
Details	Last Recertification Date	Insert	New Registration			4/14/2023 10:01 AM
Details	Grant Number	Insert	New Registration			4/14/2023 10:01 AM
Details	340B ID	Insert	New Registration			4/14/2023 10:01 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/14/2023 10:01 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/14/2023 10:01 AM
Details	Medicare Provider Number	Insert	New Registration		390326	4/14/2023 10:01 AM
Details	Entity Name	Insert	New Registration		ST LUKE HOSPITAL ANDERSON CAMPUS	4/14/2023 10:01 AM
Details	NOFO Number	Insert	New Registration			4/14/2023 10:01 AM
Details	Program Code	Insert	New Registration		DSH	4/14/2023 10:01 AM
Details	Entity Subname	Insert	New Registration		ST LUKES HOSPITAL ANDERSON CAMPUS	4/14/2023 10:01 AM
Dates	Participating Approval Date	Insert	New Registration			4/14/2023 10:01 AM
Details	State	Insert	New Registration		Pending	4/14/2023 10:01 AM
Dates	Registration Date	Insert	New Registration		4/14/2023 10:01:08 AM	4/14/2023 10:01 AM
Dates	Signed By Date	Insert	New Registration			4/14/2023 10:01 AM
Dates	Start Date	Insert	New Registration			4/14/2023 10:01 AM
Terminations	Termination Comments	Insert	New Registration			4/14/2023 10:01 AM
Terminations	Termination Date	Insert	New Registration			4/14/2023 10:01 AM
Terminations	Termination Effective Date	Insert	New Registration			4/14/2023 10:01 AM
Terminations	Termination Reason	Insert	New Registration			4/14/2023 10:01 AM