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DSH140228BG SWEDISH AMERICAN HOSPITAL (Active)
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Main Details
Name
SWEDISH AMERICAN HOSPITAL
Subdivision Name
NORTH ALPINE CLINIC - UWNI NAC ENT
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140228BG
Medicare Provider Number
140228
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2025
Participating Start Date
4/1/2025
Participating Approval Date
1/31/2025
Last Recertification Date
Contacts
Authorizing Official
SwedishAmerican Hospital
Patricia Ann DeWane, Vice President, Finance and Treasurer
(779) 696-4009
Primary Contact
SwedishAmerican Hospital
Tom Carey, Director of Pharmacy Services
(779) 696-4580
Addresses
Street Address
1253 N ALPINE RD
ROCKFORD, IL 61107
Billing Address
SwedishAmerican Hospital
1401 E STATE ST
ROCKFORD, IL 61104
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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