340B Drug Pricing Program Database
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DSH260104F SSM HEALTH DEPAUL HOSPITAL (Active)
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Main Details
Name
SSM HEALTH DEPAUL HOSPITAL
Subdivision Name
Dorsett Urgent Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260104F
Medicare Provider Number
260104
Outpatient Facility Provider Number
260104
Additional Details
Current Program Status
Active
Registration Date
7/7/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/29/2014
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
SSM Health
Eileen Lamm, Regional Vice President-Finance
(314) 994-6219
Primary Contact
SSM Health
Holly Herring, Director, 340B Center of Excellence
(580) 512-7188
Addresses
Street Address
2022 Dorsett Village
Maryland Heights, MO 63043
Billing Address
SSM DePaul Health Center
12303 DePaul Drive
Bridgeton, MO 63044
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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