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DSH260020J MERCY HOSPITAL - ST. LOUIS (ToBeTerminated)
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Main Details
Name
MERCY HOSPITAL - ST. LOUIS
Subdivision Name
MERCY HOSPITAL ST. LOUIS - STLO PEDIATRIC INFUSION-PRATT
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260020J
Medicare Provider Number
260020
Outpatient Facility Provider Number
Additional Details
Current Program Status
ToBeTerminated
Registration Date
10/4/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/27/2017
Last Recertification Date
8/21/2024
Termination Date
Termination Reason
7/1/2025
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Mercy Hospital St. Louis
Denise Scoffic, VP Finance
(314) 364-3553
Primary Contact
Mercy Shared Services
Mike Loftus, Director-Hospital Pharmacy
(417) 820-3487
Addresses
Street Address
607 S NEW BALLAS RD
ST LOUIS, MO 63141-8222
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
May 2025
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