340B Drug Pricing Program Database
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RWI63139 Southampton Community Healthcare, Inc (Active)
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Main Details
Name
Southampton Community Healthcare, Inc
Subdivision Name
Type
Ryan White Part A
340B ID
RWI63139
Grant Number
H89HA00033
Additional Details
Current Program Status
Active
Registration Date
10/20/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/2/2022
Last Recertification Date
2/27/2025
Time Period the Assistance was Received
3/1/2025 - 2/28/2026
Contacts
Authorizing Official
Southampton Community Healthcare, Inc
David James Prelutsky, President
(314) 276-3090
Primary Contact
Southampton Community Healthcare, Inc
Jeff Wilsman, Practice Administrator
(314) 276-3090
Addresses
Street Address
2340 Hampton Ave
Saint Louis, MO 63139
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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