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DSH520075H ST.VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS (Active)
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Main Details
Name
ST.VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS
Subdivision Name
HSHS St. Vincent Cancer Center at HSHS St. Mary's Medical Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH520075H
Medicare Provider Number
520075
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/13/2015
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
HSHS
Michael Scialdone, SVP-Chief Financial Officer
(217) 492-6594
Primary Contact
HSHS St. Vincent Hospital
Susan Wheeler, PHARMACY DIRECTOR
(920) 459-4687
Addresses
Street Address
1726 SHAWANO AVENUE
GREEN BAY, WI 54303
Billing Address
Consolidated Services
PO Box 3646
Springfield, IL 62708
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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