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SCH140161-00 Saint James Hospital (Terminated)
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Main Details
Name
Saint James Hospital
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH140161-00
Medicare Provider Number
140161
Additional Details
Current Program Status
Terminated
Registration Date
10/12/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/18/2012
Last Recertification Date
8/16/2016
Termination Date
Termination Reason
4/1/2017
DSH percentage below statutory minimum
Contacts
Authorizing Official
Diane Marie McGrew, President
(309) 655-2850
Primary Contact
OSF Healthcare
Jerry Storm, Senior Vice President of Pharmacy Services
(309) 655-3489
Addresses
Street Address
2500 W. Reynolds Street
Pontiac, IL 61764
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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