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DSH260005AW SSM ST. JOSEPH HEALTH CENTER (Terminated)
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Main Details
Name
SSM ST. JOSEPH HEALTH CENTER
Subdivision Name
SJHC Radiology - Therapeutic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260005AW
Medicare Provider Number
260005
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/9/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/12/2015
Last Recertification Date
8/22/2019
Termination Date
Termination Reason
12/18/2019
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
SSM Health
Eileen Lamm, Regional Vice President-Finance
(314) 994-6219
Primary Contact
SSM Health
Jeffrey Peine, Finance Director
(314) 989-3532
Addresses
Street Address
500 Medical Drive
Wentzville, MO 63385
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
May 2025
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