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DSH520075 ST.VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS (Active)
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Main Details
Name
ST.VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH520075
Medicare Provider Number
520075
Additional Details
Current Program Status
Active
Registration Date
12/3/2009
Participating Start Date
1/1/2010
Participating Approval Date
12/4/2009
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
HSHS
Patty Allen, Chief Financial Officer
(920) 884-5660
Primary Contact
HSHS St. Vincent Hospital
Susan Wheeler, PHARMACY DIRECTOR
(920) 459-4687
Addresses
Street Address
835 S.VAN BUREN STREET
GREEN BAY, WI 54301
Billing Address
Consolidated Services
PO Box 3646
Springfield, IL 62708
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/25/2010- DOC. RECD. TO CONFIRM ELIG. DSH PERCENTAGE
06/25/2010
April 2025
April 2025
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