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DSH260091AM SSM HEALTH ST MARY'S HOSPITAL-STL (Active)
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Main Details
Name
SSM HEALTH ST MARY'S HOSPITAL-STL
Subdivision Name
SSMMG Internal Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260091AM
Medicare Provider Number
260091
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/8/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/15/2015
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
1035 Bellevue Avenue
Suite 305
Richmond Heights, MO 63117-1811
Billing Address
St. Mary's Hospital
6420 Clayton Road
St. Louis, MO 63117
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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