340B Drug Pricing Program Database
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DSH520009AA Ascension NE Wisconsin, Inc. d/b/a Ascension NE Wisconsin - St. Elizabeth Hospital Campus (Approved)
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Main Details
Name
Ascension NE Wisconsin, Inc. d/b/a Ascension NE Wisconsin - St. Elizabeth Hospital Campus
Subdivision Name
Koeller Urgent Care - Urgent Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH520009AA
Medicare Provider Number
520009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/2/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/7/2025
Last Recertification Date
Contacts
Authorizing Official
Ascension Wisconsin
Michael Bergmann, President
(920) 831-8913
Primary Contact
Ascension WI
Cescilly Smith-Jenkins, 340B Program Director – Wisconsin
(414) 522-7533
Addresses
Street Address
1855 S Koeller St
Oshkosh, WI 54902
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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