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DSH260091AS SSM ST MARY'S HEALTH CENTER (Terminated)
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Main Details
Name
SSM ST MARY'S HEALTH CENTER
Subdivision Name
SSM Cancer Care Radiation Oncology SMHC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260091AS
Medicare Provider Number
260091
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/8/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/24/2015
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
6400 CLAYTON ROAD, SUITE 302
RICHMOND HEIGHTS, MO 63117
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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