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DSH380047 St. Charles Health System, Inc., d/b/a St. Charles Bend (Active)
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Main Details
Name
St. Charles Health System, Inc., d/b/a St. Charles Bend
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH380047
Medicare Provider Number
380047
Additional Details
Current Program Status
Active
Registration Date
4/15/2016
Participating Start Date
7/1/2016
Participating Approval Date
6/6/2016
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
St. Charles Health System
Matt Swafford, SVP and CFO
(541) 706-7707
Primary Contact
St. Charles Health System
Jennifer Beth Stubblefield, Pharmacy Revenue Integrity Specialist
(541) 706-6978
Addresses
Street Address
2500 NE NEFF ROAD
BEND, OR 97701
Billing Address
St. Charles Medical Center Bend
PO BOX 5789
Bend, OR 97708
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Hospital previously participated as RRC380047-00 from 7/1/12 through 6/30/16.
06/03/2016
April 2025
April 2025
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