340B Drug Pricing Program Database
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DSH140290 ST. ALEXIUS MEDICAL CENTER (Active)
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Main Details
Name
ST. ALEXIUS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140290
Medicare Provider Number
140290
Additional Details
Current Program Status
Active
Registration Date
4/12/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/17/2017
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Ascension - Saint Alexius Medical Center
Ronald Farr, CFO
(847) 490-6901
Primary Contact
Ascension Rx
Kelsey Fiser, 340B Program Director
(615) 222-5190
Addresses
Street Address
1555 BARRINGTON ROAD
HOFFMAN ESTATES, IL 60169
Billing Address
ASCENSION HEALTH MINISTRY SERVICE
VENDOR INVOICES
PO BOX 33902
INDIANAPOLIS, IN 46203
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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