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DSH040020K ST BERNARDS HOSPITAL INC DBA ST BERNARDS MEDICAL CENTER (Active)
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Main Details
Name
ST BERNARDS HOSPITAL INC DBA ST BERNARDS MEDICAL CENTER
Subdivision Name
St. Bernards Wound Healing
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH040020K
Medicare Provider Number
040020
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/8/2014
Participating Start Date
7/1/2014
Participating Approval Date
5/13/2014
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
St Bernards Healthcare
Benjamin F Barylske, VP of Finance / CFO
(870) 207-4565
Primary Contact
St. Bernards Medical Center
James Douglas Welborn, Assistant Vice President of Pharmacy Services
(870) 207-1800
Addresses
Street Address
505 East Mathews Ave., Suite 201
Jonesboro, AR 72401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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