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DSH140114M SWEDISH COVENANT HEALTH (Active)
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Main Details
Name
SWEDISH COVENANT HEALTH
Subdivision Name
Swedish Hospital - Oncology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140114M
Medicare Provider Number
140114
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/5/2024
Participating Start Date
7/1/2024
Participating Approval Date
5/28/2024
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Swedish Covenant Health
Jonathan Lind, Chief Operating Officer
(773) 907-1028
Primary Contact
Swedish Covenant Health
Alicia Juska, Director Pharmacy
(773) 878-8200 Ext: 5379
Addresses
Street Address
757 PARK AVE W
STE 1810
HIGHLAND PARK, IL 60035-2558
Billing Address
Swedish Covenant Health
5145 N CALIFORNIA AVE
CHICAGO, IL 60625
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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