340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH140012AB OSF Saint Katharine Medical Center (Active)
Print
Main Details
Name
OSF Saint Katharine Medical Center
Subdivision Name
Polo Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140012AB
Medicare Provider Number
140012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2024
Participating Start Date
7/1/2024
Participating Approval Date
5/1/2024
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
OSF HealthCare
Sandra Salverson, SVP Pharmacy Services
(309) 624-8817
Primary Contact
OSF Healthcare
amy krantz, Manager Strategic Reimbursement
(309) 655-2865
Addresses
Street Address
1107 S Division Ave.
Polo, IL 61064
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Participating Start Date 10/1/2017, Termination Date 7/1/2019, Reinstatement 7/1/2024
04/30/2024
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session