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DSH180025 ST. JOE. - FLAGET (Active)
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Main Details
Name
ST. JOE. - FLAGET
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180025
Medicare Provider Number
180025
Additional Details
Current Program Status
Active
Registration Date
1/15/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/19/2016
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Flaget Memorial Hospital
Jennifer C Nolan, President
(502) 350-5044
Primary Contact
Flaget Memorial Hospital
Michelle E Mattingly, Director of Pharmacy
(502) 350-5232
Addresses
Street Address
4305 NEW SHEPHERDSVILLE RD
BARDSTOWN, KY 40004
Billing Address
Catholic Health Initiative
P.O. Box 2400
Phoenix, AZ 85002
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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