340B Drug Pricing Program Database
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DSH140080 PRESENCE SAINT FRANCIS HOSPITAL (Active)
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Main Details
Name
PRESENCE SAINT FRANCIS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140080
Medicare Provider Number
140080
Additional Details
Current Program Status
Active
Registration Date
6/5/2007
Participating Start Date
7/1/2007
Participating Approval Date
6/6/2007
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
PrimeHealthCare
George Edward Pepe, CFO
(847) 347-4648
Primary Contact
Prime Healthcare
Rick Fischer, Regional 340 Program Director
(630) 309-7828
Addresses
Street Address
355 RIDGE AVE.
EVANSTON, IL 60202
Billing Address
Ascension Health Ministry Service Center
PO Box 33902
Indianapolis, IN 46203
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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9/12/13 documents from FI and entity show shortened cost reporting period due to merger without change of medicaid number JH
09/12/2013
April 2025
April 2025
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