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DSH520096E WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS (Terminated)
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Main Details
Name
WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS
Subdivision Name
WHEATON FRANCISCAN MEDICAL GROUP
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH520096E
Medicare Provider Number
520096
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
8/31/2006
Participating Start Date
4/1/2004
Participating Approval Date
8/31/2006
Last Recertification Date
11/28/2017
Termination Date
Termination Reason
4/1/2018
Other
Contacts
Authorizing Official
Ascension
Vanessa Freitag, Vice President, Pharmacy
(715) 897-1183
Primary Contact
Ascension WI
Cescilly Smith-Jenkins, 340B Program Director – Wisconsin
(414) 522-7533
Addresses
Street Address
1120 MAIN STREET
UNION GROVE, WI 53128
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/31/06 - NAME CHANGE (FORMERLY ALL SAINTS MEDICAL CENTER, INC., ALL SAINTS MEDICAL GROUP - UNION GROVE)
08/31/2006
May 2025
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