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DSH180025B ST. JOE. - FLAGET (Active)
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Main Details
Name
ST. JOE. - FLAGET
Subdivision Name
Flaget Memorial Hospital Pain Management
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180025B
Medicare Provider Number
180025
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/11/2016
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
4359 New Shepherdsville Road
Suite 155
Bardstown, KY 40004
Billing Address
Catholic Health Initiatives
P.O. Box 2400
Phoenix, AZ 85002
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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