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DSH260020AV MERCY HOSPITAL - ST. LOUIS (Active)
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Main Details
Name
MERCY HOSPITAL - ST. LOUIS
Subdivision Name
MERCY HOSPITAL ST LOUIS - Gastroenterology Lake Saint Louis
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260020AV
Medicare Provider Number
260020
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/7/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/17/2024
Last Recertification Date
Contacts
Authorizing Official
Mercy Hospital St. Louis
Denise Scoffic, VP Finance
(314) 364-3553
Primary Contact
Mercy Shared Services
Mike Loftus, Director-Hospital Pharmacy
(417) 820-3487
Addresses
Street Address
200 BREVCO PLZ
STE 208
LAKE ST LOUIS, MO 63367-2950
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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