340B Drug Pricing Program Database
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RRC150082-43 DEACONESS HOSPITAL (Active)
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Main Details
Name
DEACONESS HOSPITAL
Subdivision Name
MTM Clinic Gateway (8070) - MTM Clinic Gateway (8070)
Type
Rural Referral Center
Rural
Yes
340B ID
RRC150082-43
Medicare Provider Number
150082
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/4/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/16/2024
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Deaconess Hospital
Cheryl Wathen, Chief Financial Officer
(812) 450-3296
Primary Contact
Deaconess Hospital
Sarah Laramie, 340B Coordinator
(270) 631-2476
Addresses
Street Address
4209 Gateway Blvd
1300
Newburgh, IN 47630
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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