340B Drug Pricing Program Database
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DSH370149L St Anthony Shawnee Hospital (Active)
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Main Details
Name
St Anthony Shawnee Hospital
Subdivision Name
St. Anthony Physicians Shawnee / Cardiology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH370149L
Medicare Provider Number
370149
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/1/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/17/2016
Last Recertification Date
8/31/2024
Contacts
Authorizing Official
- SSM ST ANTHONY HOSPITAL
Shasta Manuel, VP of Finance CFO
(405) 272-7282
Primary Contact
SSM Health
Nathan Przybysz, 340b Program Manager
(314) 989-2214
Addresses
Street Address
3315 Kethley Road
Shawnee, OK 74804
Billing Address
St. Anthony Shawnee Hospital
1102 W Mac Arthur
Shawnee, OK 74804
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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