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DSH370037AW SSM ST ANTHONY HOSPITAL (ToBeTerminated)
Main Details
Name
SSM ST ANTHONY HOSPITAL
Subdivision Name
SAS-Partial Hospital / SAP BHS STAGES - SAS-Partial Hospital / SAP BHS STAGES
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH370037AW
Medicare Provider Number
370037
Outpatient Facility Provider Number
Contacts
Authorizing Official
- SSM ST ANTHONY HOSPITAL
Shasta Manuel, VP of Finance CFO
(405) 272-7282
Primary Contact
SSM Health
Michelle Nicole Schmitt, Director of Business Operations
(608) 294-6203
Additional Details
Current Program Status
ToBeTerminated
Registration Date
10/14/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/8/2022
Last Recertification Date
8/31/2023
Termination Date
7/1/2024
Termination Reason
Business decision by the Covered Entity
Addresses
Street Address
2129 SW 59th St
OKLAHOMA CITY, OK 73119
Billing Address
SSM ST ANTHONY HOSPITAL
1000 N Lee Ave
Oklahoma City, OK 73102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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