340B Drug Pricing Program Database
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DSH520096DX Ascension All Saints Hospital, Inc. (Active)
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Main Details
Name
Ascension All Saints Hospital, Inc.
Subdivision Name
Wisconsin Avenue Adolescent Day Treatment - Behavioral Health
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH520096DX
Medicare Provider Number
520096
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/8/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/8/2024
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Ascension All Saints
Kristin Aileen McManmon, President & CEO
(262) 687-4886
Primary Contact
Ascension WI
Cescilly Smith-Jenkins, 340B Program Director – Wisconsin
(414) 522-7533
Addresses
Street Address
1320 Wisconsin Avenue
Racine, WI 53403-1978
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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