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DSH040020AG ST BERNARDS HOSPITAL INC DBA ST BERNARDS MEDICAL CENTER (Approved)
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Main Details
Name
ST BERNARDS HOSPITAL INC DBA ST BERNARDS MEDICAL CENTER
Subdivision Name
St. Bernards Heart and Vascular-Osceola - Cardiology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH040020AG
Medicare Provider Number
040020
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/11/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/24/2025
Last Recertification Date
Contacts
Authorizing Official
St Bernards Healthcare
Benjamin F Barylske, VP of Finance / CFO
(870) 207-4565
Primary Contact
St. Bernards Medical Center
James Douglas Welborn, Assistant Vice President of Pharmacy Services
(870) 207-1800
Addresses
Street Address
1420 West Keiser Ave.
Osceola, AR 72370
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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