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DSH170133 SAINT LUKE'S CUSHING HOSPITAL (Terminated)
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Main Details
Name
SAINT LUKE'S CUSHING HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH170133
Medicare Provider Number
170133
Additional Details
Current Program Status
Terminated
Registration Date
9/16/2009
Participating Start Date
10/1/2009
Participating Approval Date
9/23/2009
Last Recertification Date
12/5/2017
Termination Date
Termination Reason
7/1/2018
DSH percentage below statutory minimum
Contacts
Authorizing Official
Saint Luke's South & Cushing Hospitals
Robert L Olm-Shipman, President & Chief Executive Officer
(913) 684-1101
Primary Contact
Saint Lukes Cushing Hospital
ROBERT Henry KATZENBERGER, DIRECTOR OF PHARMACY
(913) 684-1157
Addresses
Street Address
711 MARSHALL STREET
LEAVENWORTH, KS 66048
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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