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DSH130013M Saint Alphonsus Medical Center Nampa (Terminated)
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Main Details
Name
Saint Alphonsus Medical Center Nampa
Subdivision Name
SAMG Wound/Hyperbaric at NHP - Wound hyperbaric
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH130013M
Medicare Provider Number
130013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/8/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/9/2020
Last Recertification Date
8/20/2024
Termination Date
Termination Reason
1/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
Saint Alphonsus Health System
Lannie Checketts, RHM CFO Idaho Oregon Region
(208) 367-7347
Primary Contact
Trinity Health
Carisa Ann McGehee, 340B Analyst
(208) 367-2087
Addresses
Street Address
4400 E Flamingo
Ste 120
Nampa, ID 83687
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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