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DSH180143G SAINT JOSEPH EAST (Terminated)
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Main Details
Name
SAINT JOSEPH EAST
Subdivision Name
Outpatient Treatment - MS, GI, RA
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180143G
Medicare Provider Number
180143
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/18/2017
Last Recertification Date
8/23/2018
Termination Date
Termination Reason
7/1/2019
Site closure
Contacts
Authorizing Official
CHI Saint Joseph's Hospital East
Lonnie Ralph Taylor, VP Patient Care Services/Operations
(859) 967-5758
Primary Contact
Saint Joseph East
Michael David DeLuca, Manager of Pharmacy Services
(859) 967-5576
Addresses
Street Address
3470 Blazer Parkway
120
Lexington, KY 40509
Billing Address
Saint Joseph East
150 North Eagle Creek Dr
Lexington, KY 40509
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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