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DSH520078L WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS (Terminated)
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Main Details
Name
WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS
Subdivision Name
WHEATON FRANCISCAN HEALTHCARE ST FR / St Francis-Metro Physician Outpatient Therapy- 2025 Oklahoma Ave Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH520078L
Medicare Provider Number
520078
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/9/2015
Last Recertification Date
11/27/2017
Termination Date
Termination Reason
10/1/2018
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Ascension
Vanessa Freitag, Vice President, Pharmacy
(715) 897-1183
Primary Contact
Ascension WI
Cescilly Smith-Jenkins, 340B Program Director – Wisconsin
(414) 522-7533
Addresses
Street Address
2025 W OKLAHOMA AVENUE
MILWAUKEE, WI 53215-4455
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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