340B Drug Pricing Program Database
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The Q2 2025 registration window for covered entities is open from 4/1/2025 - 4/15/2025.
DSH140276A LOYOLA UNIVERSITY MEDICAL CENTER (Active)
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Main Details
Name
LOYOLA UNIVERSITY MEDICAL CENTER
Subdivision Name
LOYOLA UNIVERSITY MEDICAL CENTER - CARDINAL BERNARDIN CANCER CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140276A
Medicare Provider Number
140276
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
3/9/2010
Participating Start Date
4/1/2010
Participating Approval Date
3/15/2010
Last Recertification Date
9/8/2024
Contacts
Authorizing Official
Loyola Medicine
Melissa M. Lukasick, CFO Illinois Region
(708) 216-5723
Primary Contact
Loyola Medicine
Zohra Saleem, Regional 340B Manager
(708) 216-3875
Addresses
Street Address
2160 SOUTH FIRST AVENUE
MAYWOOD, IL 60153-3304
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/3/2010- DOC. RECD. TO CONFIRM DSH ADJ. %.
03/09/2010
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