340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH140185AQ MEMORIAL HOSPITAL (Active)
Print
Main Details
Name
MEMORIAL HOSPITAL
Subdivision Name
Mhb Wound Care - Mhb Wound Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140185AQ
Medicare Provider Number
140185
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/11/2024
Participating Start Date
7/1/2024
Participating Approval Date
5/9/2024
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Christain Hospital - BJC
Susan Koesterer, VP, Chief Financial Officer
(314) 653-5715
Primary Contact
Memorial Hospital
Ryan Birk, Director of Pharmacy
(618) 606-0210
Addresses
Street Address
4600 Memorial Drive
Belleville, IL 62226
Billing Address
BJC Healthcare
4249 Clayton Avenue 310
St. Louis, MO 63110
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session