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SCH140064-01 ST. MARY MEDICAL CENTER (Active)
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Main Details
Name
ST. MARY MEDICAL CENTER
Subdivision Name
ST MARY MEDICAL CENTER - OSF Healthcare Medical Group Abingdon
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH140064-01
Medicare Provider Number
140064
Outpatient Facility Provider Number
148638
Additional Details
Current Program Status
Active
Registration Date
1/14/2025
Participating Start Date
4/1/2025
Participating Approval Date
3/13/2025
Last Recertification Date
Contacts
Authorizing Official
OSF HealthCare
Sandra Salverson, SVP Pharmacy Services
(309) 624-8817
Primary Contact
OSF Healthcare
amy krantz, Manager Strategic Reimbursement
(309) 655-2865
Addresses
Street Address
100 N MONROE ST
OSF HEALTHCARE - MEDICAL GROUP - ABINGDON
ABINGDON, IL 61410-1457
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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