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RRC140046-00 GOOD SAMARITAN REGIONAL HEALTH CTR. (Terminated)
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Main Details
Name
GOOD SAMARITAN REGIONAL HEALTH CTR.
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC140046-00
Medicare Provider Number
140046
Additional Details
Current Program Status
Terminated
Registration Date
5/26/2011
Participating Start Date
10/1/2015
Participating Approval Date
6/16/2011
Last Recertification Date
9/14/2022
Termination Date
Termination Reason
7/1/2023
Change of covered entity type
Contacts
Authorizing Official
SSM Health
Eileen Lamm, Regional Vice President-Finance
(314) 994-6219
Primary Contact
SSM Health
Anita McAllister, System Director of 340B Operations
(314) 989-6778
Addresses
Street Address
1 GOOD SAMARITAN WAY
MT. VERNON, IL 62864
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 7/1/11, terminated 7/1/12 through 10/1/15 due to DSH percentage below statutory minimum, reinstated based on new registration submitted in July 2015
08/11/2015
April 2025
April 2025
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