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DSH140029B COPLEY MEMORIAL HOSPITAL (Active)
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Main Details
Name
COPLEY MEMORIAL HOSPITAL
Subdivision Name
RUSH COPLEY CANCER CARE CLINIC YORK
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140029B
Medicare Provider Number
140029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/19/2016
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Rush University System for Health
Kate Marie Schaafsma, VP, Chief Pharmacy Officer
(815) 592-4299
Primary Contact
Copley Memorial Hospital
Stacey Ries, Deputy General Counsel
(630) 499-4721
Addresses
Street Address
1100W VETERANS PKWY
YORKVILLE, IL 60560-4728
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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