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DSH380047A 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
St. Charles Cancer Center - Bend
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH380047A
Medicare Provider Number
380047
Outpatient Facility Provider Number
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 RD
CNCR FLR2
Bend, OR 97701
Billing Address
St. Charles Medical Center Bend dba/St, Charles Cancer Center Bend
PO Box 5789
Bend, OR 97708
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/6/16 Hospital previously participated as RRC380047-01 from 10/1/12 through 6/30/16
06/06/2016
Hospital previously participated as RRC380047-01 from 10/1/12 through 6/30/16.
06/03/2016
April 2025
April 2025
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