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DSH140114 SWEDISH COVENANT HEALTH (Active)
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Main Details
Name
SWEDISH COVENANT HEALTH
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140114
Medicare Provider Number
140114
Additional Details
Current Program Status
Active
Registration Date
4/21/2008
Participating Start Date
7/1/2004
Participating Approval Date
4/21/2008
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Swedish Covenant Health
Jonathan Lind, Chief Operating Officer
(773) 907-1028
Primary Contact
Swedish Covenant Health
Alicia Juska, Director Pharmacy
(773) 878-8200 Ext: 5379
Addresses
Street Address
5145 N CALIFORNIA
CHICAGO, IL 60625
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/23/12 remove Medicaid info 8/31/04 MODIF ADDR (WAS 2745 W FOSTER AVENUE, ZIP 60613)
02/23/2012
8/31/04 MODIF ADDR (WAS 2745 W FOSTER AVENUE, ZIP 60613)
04/21/2008
April 2025
April 2025
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