340B Drug Pricing Program Database
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DSH140180E Presence Saints Mary and Elizabeth Medical Center (Terminated)
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Main Details
Name
Presence Saints Mary and Elizabeth Medical Center
Subdivision Name
OP Behavioral Health
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140180E
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
8/13/2024
Termination Date
Termination Reason
4/1/2025
For-Profit conversion
Contacts
Authorizing Official
Ascension Saint Mary & Elizabeth MEdical Center
Eric Zornow, CFO
(312) 770-2105
Primary Contact
Ascension
Rick Fischer, 340B Program Director
(630) 309-7828
Addresses
Street Address
1127 N. OAKLEY BLVD
Chicago, IL 60622
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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