340B Drug Pricing Program Database
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CAH141349-00 Sparta Community Hospital District (Active)
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Main Details
Name
Sparta Community Hospital District
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141349-00
Medicare Provider Number
141349
Additional Details
Current Program Status
Active
Registration Date
10/8/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/31/2012
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Sparta Community Hospital District
Lisa A Ernsting, CFO
(618) 443-2177 Ext: 1403
Primary Contact
Sparta Community Hospital - 417106
Quenci Peper, Director of Pharmacy
(618) 443-1460
Addresses
Street Address
818 East Broadway Street
Sparta, IL 62286
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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