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DSH370037BS SSM ST ANTHONY HOSPITAL (Active)
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Main Details
Name
SSM ST ANTHONY HOSPITAL
Subdivision Name
SAPO Healthplex Mustang Pediatrics - Pediatrics
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH370037BS
Medicare Provider Number
370037
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/10/2024
Participating Start Date
7/1/2024
Participating Approval Date
6/13/2024
Last Recertification Date
8/31/2024
Contacts
Authorizing Official
- SSM ST ANTHONY HOSPITAL
Shasta Manuel, VP of Finance CFO
(405) 272-7282
Primary Contact
SSM Health
Michelle Nicole Schmitt, Director of Business Operations
(608) 294-6203
Addresses
Street Address
201 S Sara Road
Suite 200
Mustang, OK 73064
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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