340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH140228AL SWEDISH AMERICAN HOSPITAL (Terminated)
Print
Main Details
Name
SWEDISH AMERICAN HOSPITAL
Subdivision Name
SWEDISH AMERICAN RENAISSANCE PAVILION - SAH UW HEALTH SURGERY AT SA FOURTH FL - SAH UW HEALTH SURGERY AT SA
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140228AL
Medicare Provider Number
140228
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/20/2023
Last Recertification Date
Termination Date
Termination Reason
4/1/2023
Other
Contacts
Authorizing Official
SwedishAmerican Hospital
Patricia Ann DeWane, Vice President, Finance and Treasurer
(779) 696-4009
Primary Contact
SwedishAmerican Hospital
Tom Carey, Director of Pharmacy Services
(779) 696-4580
Addresses
Street Address
1340 CHARLES ST
STE 405
ROCKFORD, IL 61104
Billing Address
SWEDISH AMERICAN HOSPITAL
1401 E STATE ST
ROCKFORD, IL 61104
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session