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DSH130013A Saint Alphonsus Medical Center Nampa (Terminated)
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Main Details
Name
Saint Alphonsus Medical Center Nampa
Subdivision Name
Caldwell Cancer Care Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH130013A
Medicare Provider Number
130013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/2/2013
Participating Start Date
4/1/2013
Participating Approval Date
3/7/2013
Last Recertification Date
8/20/2024
Termination Date
Termination Reason
1/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
Saint Alphonsus Health System
Lannie Checketts, RHM CFO Idaho Oregon Region
(208) 367-7347
Primary Contact
Trinity Health
Carisa Ann McGehee, 340B Analyst
(208) 367-2087
Addresses
Street Address
3123 Medical Drive
Caldwell, ID 83605
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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