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DSH260091A SSM HEALTH ST MARY'S HOSPITAL-STL (Active)
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Main Details
Name
SSM HEALTH ST MARY'S HOSPITAL-STL
Subdivision Name
SSM CARDINAL GLENNON CHILDRENS HOSPITAL
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260091A
Medicare Provider Number
260091
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
11/29/2006
Participating Start Date
1/1/2007
Participating Approval Date
11/30/2006
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
SSM Health
Eileen Lamm, Regional Vice President-Finance
(314) 994-6219
Primary Contact
SSM Health
Holly Herring, Director, 340B Center of Excellence
(580) 512-7188
Addresses
Street Address
1465 S GRAND BLVD
ST. LOUIS, MO 63104
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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FEB. 5, 2007 - REMOVED MEDICAID NUMBER PER REQUEST FROM TIM FRANKE (WAS 600155808)
11/29/2006
April 2025
April 2025
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