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DSH260091U SSM HEALTH ST MARY'S HOSPITAL-STL (Active)
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Main Details
Name
SSM HEALTH ST MARY'S HOSPITAL-STL
Subdivision Name
SSM Cardinal Glennon Children's Hospital Electrocardiology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260091U
Medicare Provider Number
260091
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/7/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/11/2015
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
1465 South Grand Blvd.
St. Louis, MO 63104
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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