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DSH260020AA MERCY HOSPITAL - ST. LOUIS (Active)
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Main Details
Name
MERCY HOSPITAL - ST. LOUIS
Subdivision Name
MERCY HOSPITAL ENDOSCOPY CENTER LAK - Endoscopy Center Lake St. Louis
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260020AA
Medicare Provider Number
260020
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/13/2023
Participating Start Date
7/1/2023
Participating Approval Date
5/10/2023
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Mercy Hospital St. Louis
Denise Scoffic, VP Finance
(314) 364-3553
Primary Contact
Mercy Shared Services
Mike Loftus, Director-Hospital Pharmacy
(417) 820-3487
Addresses
Street Address
200 BREVCO PLAZA
STE 207
LAKE ST LOUIS, MO 63367-2950
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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