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DSH160146 ST. LUKE'S REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
ST. LUKE'S REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH160146
Medicare Provider Number
160146
Additional Details
Current Program Status
Active
Registration Date
12/16/2008
Participating Start Date
1/1/2009
Participating Approval Date
12/16/2008
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
St Luke's Regional Medical Center
Leah Knapp, Vice President of Finance
(712) 279-3824
Primary Contact
St. Luke's Regional Medical Center
Paula K. Emerson, Pharmacy Manager
(712) 266-2630
Addresses
Street Address
2720 STONE PARK BLVD
SIOUX CITY, IA 51104
Billing Address
UnityPoint Health Accounts Payable
PO Box 5048
Rock Island, IL 61204
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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1/11/12 Change AO from Johnson to Gobell JH 8/2/2009- ADDED MEDICAID NUMBER AND NPI; 2/20/09 - DOCUMENTS RECD TO CONFIRM ELIGIBLE DSH ADJ%
01/11/2012
8/2/2009- ADDED MEDICAID NUMBER AND NPI; 2/20/09 - DOCUMENTS RECD TO CONFIRM ELIGIBLE DSH ADJ%
08/02/2009
May 2025
May 2025
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