340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH140180D Presence Saints Mary and Elizabeth Medical Center (Terminated)
Print
Main Details
Name
Presence Saints Mary and Elizabeth Medical Center
Subdivision Name
OP Behavioral Health
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140180D
Medicare Provider Number
140180
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/29/2016
Last Recertification Date
8/17/2018
Termination Date
Termination Reason
4/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
AMITA Health Sts Mary - Kankakee
Michael James Mulay, CFO
(773) 990-8611
Primary Contact
Presence Health
Rick Fischer, System Director, 340B
(630) 914-2872
Addresses
Street Address
1431 N. Claremont
Chicago, IL 60622
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session