340B Drug Pricing Program Database
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DSH040020M ST BERNARDS HOSPITAL INC DBA ST BERNARDS MEDICAL CENTER (Terminated)
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Main Details
Name
ST BERNARDS HOSPITAL INC DBA ST BERNARDS MEDICAL CENTER
Subdivision Name
St. Bernards Specialty Clinic I -Behaviorial Health and PAT- Paragould
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH040020M
Medicare Provider Number
040020
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/3/2017
Last Recertification Date
8/31/2019
Termination Date
Termination Reason
10/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
St Bernards Healthcare
Benjamin F Barylske, VP of Finance / CFO
(870) 207-4565
Primary Contact
St. Bernards Medical Center
James Douglas Welborn, Assistant Vice President of Pharmacy Services
(870) 207-1800
Addresses
Street Address
4000 Linwood Drive Suite B
Paragould, AR 72450
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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