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RRC370025-08 Saint Francis Hospital Muskogee (Terminated)
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Main Details
Name
Saint Francis Hospital Muskogee
Subdivision Name
Xavier Building - Bone Density
Type
Rural Referral Center
Rural
Yes
340B ID
RRC370025-08
Medicare Provider Number
370025
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/10/2022
Last Recertification Date
9/12/2022
Termination Date
Termination Reason
1/1/2023
Change of covered entity type
Contacts
Authorizing Official
Saint Francis Health System
Deborah D Dage, SRVP/Chief Financial Officer
(918) 494-8418
Primary Contact
Saint Francis Health System
Robert Douglas Walker, Manager, Pharmacy
(918) 494-1059
Addresses
Street Address
101 Rockefeller Drive
Suite 101
Muskogee, OK 74401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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