340B Drug Pricing Program Database
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DSH260104AF SSM DEPAUL HEALTH CENTER (Terminated)
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Main Details
Name
SSM DEPAUL HEALTH CENTER
Subdivision Name
DPMG Spec DPHC Gen
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260104AF
Medicare Provider Number
260104
Outpatient Facility Provider Number
260104
Additional Details
Current Program Status
Terminated
Registration Date
7/7/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/29/2014
Last Recertification Date
9/16/2022
Termination Date
Termination Reason
1/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
SSM Health
Eileen Lamm, Regional Vice President-Finance
(314) 994-6219
Primary Contact
Spendmend
Chelsea Violette, Director of Optimization
(845) 206-6019
Addresses
Street Address
12255 DePaul Drive
Suite 500
Bridgeton, MO 63044
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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