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DSH260104 SSM HEALTH DEPAUL HOSPITAL (Active)
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Main Details
Name
SSM HEALTH DEPAUL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260104
Medicare Provider Number
260104
Additional Details
Current Program Status
Active
Registration Date
8/28/2006
Participating Start Date
10/1/2006
Participating Approval Date
8/29/2006
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
SSM Health
Karen D. Rewerts, System VP of Finance
(557) 203-3614
Primary Contact
SSM Health
Michelle Nicole Schmitt, VP Pharmacy Financial Operations
(608) 294-6203
Addresses
Street Address
12303 DePaul Dr
BRIDGETON, MO 63044
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/27/2011- DOC.RECD. TO CONFIRM NON-PROFIT STATUS 3/24/2010- DOC. RECD. TO CONFIRM ELIG. OWNERSHIP TYPE; 9/24/09 REMOVED MEDICAID PROVIDER # (WAS 010494102 AND 600128409)
07/06/2011
6/27/2011- DOC.RECD. TO CONFIRM NON-PROFIT STATUS 3/24/2010- DOC. RECD. TO CONFIRM ELIG. OWNERSHIP TYPE; 9/24/09 REMOVED MEDICAID PROVIDER # (WAS 010494102 AND 600128409)
07/06/2011
June 2025
June 2025
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