340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH100307J ASCENSION ST. VINCENTS SOUTHSIDE HO (Active)
Print
Main Details
Name
ASCENSION ST. VINCENTS SOUTHSIDE HO
Subdivision Name
ORANGE PARK RHEUMATOLOGY - Rheumatology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100307J
Medicare Provider Number
100307
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/1/2025
Participating Start Date
1/21/2025
Participating Approval Date
1/21/2025
Last Recertification Date
Contacts
Authorizing Official
Sacred Heart Health System, Inc.
Susan Cornejo, Chief Operating Officer
(850) 416-6206
Primary Contact
Sacred Heart Health System, Inc.
Troy Russo, 340B Coordinator
(850) 416-2859
Addresses
Street Address
2300 PARK AVE
STE 204
ORANGE PARK, FL 32073-5573
Billing Address
Same as Street Address
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.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
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