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DSH260005AA SSM HEALTH ST. JOSEPH HOSPITAL- SC (Active)
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Main Details
Name
SSM HEALTH ST. JOSEPH HOSPITAL- SC
Subdivision Name
SCCMG St. Peters IM/FP
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260005AA
Medicare Provider Number
260005
Outpatient Facility Provider Number
260005
Additional Details
Current Program Status
Active
Registration Date
7/7/2015
Participating Start Date
10/1/2015
Participating Approval Date
8/18/2015
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
6994 Mexico Road
St. Peters, MO 63376
Billing Address
St. Joseph Hospital
300 First Capitol Drive
St. Charles, MO 63301
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/18/15 participating 10/1/2014 thru 12/31/14, not participating 1/1/15 thru 9/30/15, reinstated effective 10/1/15 based on on-line registration submitted in July 2015
08/18/2015
April 2025
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