340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SSM ST CHARLES CLINIC MED GRP INC
DSH260005 SSM HEALTH ST. JOSEPH HOSPITAL- SC
Print
Covered Entity Details
Entity Name
SSM HEALTH ST. JOSEPH HOSPITAL- SC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260005
Entity Address
300 FIRST CAPITOL DRIVE
ST. CHARLES, MO 63301
Medicare Provider Number
260005
Participating Start Date
10/1/2010
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
SSM ST CHARLES CLINIC MED GRP INC
Pharmacy Address
711 VETERANS MEMORIAL PARKWAY
SUITE 102
SAINT CHARLES, MO 63303
Pharmacy Comments
Contract Details
Approval Date
4/19/2019
Contract Begin Date
4/19/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/31/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Karen D. Rewerts, Regional VP of Financa/CFO
(314) 989-2034
Contract Pharmacy Representative
SSM Health
Nicole Maywright, Phamaccy Team Leader
(636) 669-2223
Signed By Date
4/19/2019
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