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DSH140067AQ SAINT FRANCIS MEDICAL CENTER (Active)
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Main Details
Name
SAINT FRANCIS MEDICAL CENTER
Subdivision Name
SAINT FRANCIS MEDICAL CENTER - Pediatric Diabetic Resource Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140067AQ
Medicare Provider Number
140067
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/13/2020
Participating Start Date
10/1/2020
Participating Approval Date
7/14/2020
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
OSF HealthCare
Sandra Salverson, SVP Pharmacy Services
(309) 624-8817
Primary Contact
OSF Healthcare
amy krantz, Manager Strategic Reimbursement
(309) 655-2865
Addresses
Street Address
530 NE GLEN OAK AVE
ADULT HOSPITALIST SERVICE
PEORIA, IL 61603-3133
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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