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DSH520096DM Ascension All Saints Hospital, Inc. (Active)
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Main Details
Name
Ascension All Saints Hospital, Inc.
Subdivision Name
ALL SAINTS MEDICAL CENTER / ST LUKE'S HOSPITAL PSYCH ADULT
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH520096DM
Medicare Provider Number
520096
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2023
Participating Start Date
4/1/2023
Participating Approval Date
2/15/2023
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Ascension All Saints
Kristin Aileen McManmon, President & CEO
(262) 687-4886
Primary Contact
Ascension WI
Cescilly Smith-Jenkins, 340B Program Director – Wisconsin
(414) 522-7533
Addresses
Street Address
1320 WISCONSIN AVENUE
RACINE, WI 53403-1978
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (04/1/2016) until terminated effective date: (04/1/2022), reinstatement effective date: (04/1/2023)
02/15/2023
May 2025
May 2025
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