340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH140164D MEMORIAL HOSPITAL OF CARBONDALE (Active)
Print
Main Details
Name
MEMORIAL HOSPITAL OF CARBONDALE
Subdivision Name
D.B.A SIH Prairie Heart Institute - OP Cardiovascular Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140164D
Medicare Provider Number
140164
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/1/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/31/2019
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
SIH
Warren Ladner, CFO
(618) 457-5200 Ext: 67130
Primary Contact
Southern Illinois Healthcare - Carbondale, IL
Katelyn Morgan, 340B Coordinator
(618) 457-5200 Ext: 67205
Addresses
Street Address
409 West Oak Street
Carbondale, IL 62901
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
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