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DSH040007 ST VINCENT INFIRMARY (Active)
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Main Details
Name
ST VINCENT INFIRMARY
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH040007
Medicare Provider Number
040007
Additional Details
Current Program Status
Active
Registration Date
2/9/2006
Participating Start Date
7/1/2003
Participating Approval Date
2/9/2006
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
CHI St. Vincent Infirmary
William G. Jones, MD, President and Chief Medical Officer
(501) 552-3571
Primary Contact
CHI St. Vincent Pharmacy
Debbie Campbell, Team Lead Pharmacist Revenue Cycle/340B
(501) 552-2800
Addresses
Street Address
#2 ST. VINCENT CIRCLE
ATTN: PHARMACY
LITTLE ROCK, AR 72205
Billing Address
ST VIN INFIRMARY PHS
ATTN: A/P
PO BOX 636000
LITTLETON, CO 80163-6000
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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09/23/10-ST VINCENT INFIRMARY(WAS ST VINCENT INFIRMARY-DOCTORS MEDICAL CTR)
02/09/2006
May 2025
May 2025
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