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DSH260091BN SSM ST MARY'S HEALTH CENTER (Terminated)
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Main Details
Name
SSM ST MARY'S HEALTH CENTER
Subdivision Name
2182-CG Peds Overland - 2182-CG Peds Overland
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260091BN
Medicare Provider Number
260091
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2019
Participating Start Date
4/1/2019
Participating Approval Date
2/7/2019
Last Recertification Date
9/16/2022
Termination Date
Termination Reason
1/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
SSM Health
Eileen Lamm, Regional Vice President-Finance
(314) 994-6219
Primary Contact
Spendmend
Chelsea Violette, Director of Optimization
(845) 206-6019
Addresses
Street Address
9553 Lackland Rd
Overland, MO 63114
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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