340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH230165AE Ascension St. John Hospital DBA Henry Ford St. John Hospital (Active)
Print
Main Details
Name
Ascension St. John Hospital DBA Henry Ford St. John Hospital
Subdivision Name
Perinatology/St John Hospital and Medical Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230165AE
Medicare Provider Number
230165
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2014
Participating Start Date
4/1/2014
Participating Approval Date
2/27/2014
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Henry Ford Hospital
Doug Clark, SVP - Corporate Finance
(313) 874-5446
Primary Contact
Henry Ford Hospital
Alexander Mansour, 340B Compliance Officer
(248) 723-0020
Addresses
Street Address
22151 Moross Road Suite 320
Detroit, MI 48236
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session