340B Drug Pricing Program Database
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DSH140067AZ SAINT FRANCIS MEDICAL CENTER (Active)
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Main Details
Name
SAINT FRANCIS MEDICAL CENTER
Subdivision Name
SFMC BEHAVIORAL HEALTH SERVICES - Adult Behavioral Health
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140067AZ
Medicare Provider Number
140067
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2023
Participating Start Date
7/1/2023
Participating Approval Date
5/9/2023
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
OSF HealthCare
Sandra Salverson, SVP Pharmacy Services
(309) 624-8817
Primary Contact
OSF Healthcare
amy krantz, Manager Strategic Reimbursement
(309) 655-2865
Addresses
Street Address
617 NE GLENDALE AVE
PEORIA, IL 61603-0001
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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