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DSH520096DW Ascension All Saints Hospital, Inc. (Terminated)
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Main Details
Name
Ascension All Saints Hospital, Inc.
Subdivision Name
Wheaton Franciscan Medical Group - All Saints Orthopedics - Sturtevant - Orthopedics
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH520096DW
Medicare Provider Number
520096
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2018
Participating Start Date
1/1/2019
Participating Approval Date
10/11/2018
Last Recertification Date
9/11/2019
Termination Date
Termination Reason
10/1/2020
Site closure
Contacts
Authorizing Official
Ascension
Vanessa Freitag, Vice President, Pharmacy
(715) 897-1183
Primary Contact
Ascension WI
Cescilly Smith-Jenkins, 340B Program Director – Wisconsin
(414) 522-7533
Addresses
Street Address
10340 Washington Ave.
Sturtevant, WI 53177
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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