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DSH520096DQ WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS (Terminated)
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Main Details
Name
WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS
Subdivision Name
CARDIOVASCULAR INSTITUTE / WFMG ANTICOAGULATION CLINIC - ALL SAINTS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH520096DQ
Medicare Provider Number
520096
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/17/2016
Last Recertification Date
11/28/2017
Termination Date
Termination Reason
4/1/2018
Other
Contacts
Authorizing Official
Ascension
Vanessa Freitag, Vice President, Pharmacy
(715) 897-1183
Primary Contact
Ascension WI
Cescilly Smith-Jenkins, 340B Program Director – Wisconsin
(414) 522-7533
Addresses
Street Address
3803 SPRING STREET
RACINE, WI 53405-1660
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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