Covered Entity Details

DSH360152K OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL (Terminated) - information as of 5/6/2025 12:02:29 AM

Main Details

Name

OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL

Subdivision Name

Anti Coagulation Clinic - Anti Coagulation Clinic

Type

Disproportionate Share Hospital

Rural

340B ID

DSH360152K

Medicare Provider Number

360152

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

7/7/2022

Participating Start Date

10/1/2022

Participating Approval Date

8/10/2022

Last Recertification Date

Termination Date
Termination Reason

1/1/2023
Never implemented the 340B Program

Contacts

Authorizing Official

OhioHealth
Brian Mccallister, Director of Finance
(614) 544-4154

Primary Contact

OhioHealth Doctors Hospital
Brigitta Miller, Site Manager - Pharmacy Services
(614) 788-5590

Addresses

Street Address

5141 West Broad St
Columbus, OH 43228

Billing Address

Doctors Hospital
5100 West Broad St
Columbus, OH 43228

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
OH	2229636	1972535052

Shipping Addresses

Shipping Address 1

Doctors Hospital
5100 West Broad St
Columbus, OH 43228

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH360152A	Child	DSH	OHIOHEALTH CORPORATION DBA DOCTORS	Victorian Village Imaging	1132 Hunter Avenue	Columbus	OH	Terminated
DSH360152B	Child	DSH	OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL	OhioHealth Heart & Vascular Physicians Beacon	5131 Beacon Hill Road, Suite 200	Columbus	OH	Active
DSH360152C	Child	DSH	OHIOHEALTH CORPORATION DBA DOCTORS	Outpatient Rehabilitation	5193 West Broad Street	Columbus	OH	Terminated
DSH360152D	Child	DSH	OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL	OHIOHEALTH HEART AND VASCULAR PHYSICIANS - MOREY	171 MOREY DR	MARYSVILLE	OH	Active
DSH360152E	Child	DSH	OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL	DIAGNOSTICS	5131 BEACON HILL RD, SUITE 300	COLUMBUS	OH	Active
DSH360152F	Child	DSH	OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL	DH HRT DISEASE MANAGEMENT	5131 Beacon Hill Rd, Suite 220C	COLUMBUS	OH	Active
DSH360152G	Child	DSH	OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL	OPG HVPDH EAGLETON CV - Cardiovascular	1076 Eagleton Blvd	London	OH	Active
DSH360152H	Child	DSH	OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL	OPG HVPDH ALLSEASON CV - Cardiovascular	4343 All Seasons Dr	Hilliard	OH	Active
DSH360152J	Child	DSH	OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL	Wound Care Clinic - Wound Care	5131 Beacon Hill Rd Suite 220D	Columbus	OH	Active
DSH360152K	Child	DSH	OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL	Anti Coagulation Clinic - Anti Coagulation Clinic	5141 West Broad St	Columbus	OH	Terminated
DSH360152L	Child	DSH	OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL	DH Infusion Center - Infusion	5141 West Broad St	Columbus	OH	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	1/1/2023 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		10/1/2022 12:00:00 AM	11/14/2022 11:01 AM
Details	State	Update	Termination Request	Active	To Be Terminated	11/14/2022 11:01 AM
Terminations	Termination Date	Update	Termination Request		1/1/2023 12:00:00 AM	11/14/2022 11:01 AM
Terminations	Termination Effective Date	Update	Termination Request		10/1/2022 12:00:00 AM	11/14/2022 11:01 AM
Terminations	Termination Reason	Update	Termination Request		Never implemented the 340B Program	11/14/2022 11:01 AM
Details	State	Update		Approved	Active	10/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		Mccallister, Brian Director of Finance OhioHealth 6145444154	8/10/2022 8:03 AM
Details	340B ID	Update	New Registration		DSH360152K	8/10/2022 8:03 AM
Details	Entity Name	Update	New Registration	DOCTORS HOSPITAL	OHIOHEALTH CORPORATION DBA DOCTORS HOSPITAL	8/10/2022 8:03 AM
Details	Entity Subname	Update	New Registration	Anti Coagulation Clinic	Anti Coagulation Clinic - Anti Coagulation Clinic	8/10/2022 8:03 AM
Dates	Participating Approval Date	Update	New Registration		8/10/2022 8:03:45 AM	8/10/2022 8:03 AM
Details	State	Update	New Registration	Pending	Approved	8/10/2022 8:03 AM
Dates	Signed By Date	Update	New Registration		7/7/2022 11:38:09 AM	8/10/2022 8:03 AM
Dates	Start Date	Update	New Registration		10/1/2022 12:00:00 AM	8/10/2022 8:03 AM
Addresses	Main Address	Insert	New Registration		5141 West Broad St Columbus, OH 43228	7/7/2022 11:38 AM
Addresses	Billing Address	Insert	New Registration		Doctors Hospital 5100 West Broad St Columbus, OH 43228	7/7/2022 11:38 AM
Addresses	Shipping Address	Insert	New Registration		Doctors Hospital 5100 West Broad St Columbus, OH 43228	7/7/2022 11:38 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/7/2022 11:38 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		2229636	7/7/2022 11:38 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		OH	7/7/2022 11:38 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1972535052	7/7/2022 11:38 AM
Medicaid Billing	NPI: State	Insert	New Registration		OH	7/7/2022 11:38 AM
Contacts	Authorizing Official	Insert	New Registration		Mccallister, Brian Director of Finance OhioHealth 6145444154	7/7/2022 11:38 AM
Contacts	Primary Contact	Insert	New Registration		Miller, Brigitta Site Manager - Pharmacy Services OhioHealth Doctors Hospital 6147885590	7/7/2022 11:38 AM
Details	Assistance Received From Date	Insert	New Registration			7/7/2022 11:38 AM
Details	Assistance Received To Date	Insert	New Registration			7/7/2022 11:38 AM
Details	Last Recertification Date	Insert	New Registration			7/7/2022 11:38 AM
Details	Grant Number	Insert	New Registration			7/7/2022 11:38 AM
Details	340B ID	Insert	New Registration			7/7/2022 11:38 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/7/2022 11:38 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/7/2022 11:38 AM
Details	Medicare Provider Number	Insert	New Registration		360152	7/7/2022 11:38 AM
Details	Entity Name	Insert	New Registration		DOCTORS HOSPITAL	7/7/2022 11:38 AM
Details	NOFO Number	Insert	New Registration			7/7/2022 11:38 AM
Details	Program Code	Insert	New Registration		DSH	7/7/2022 11:38 AM
Details	Entity Subname	Insert	New Registration		Anti Coagulation Clinic	7/7/2022 11:38 AM
Dates	Participating Approval Date	Insert	New Registration			7/7/2022 11:38 AM
Details	State	Insert	New Registration		Pending	7/7/2022 11:38 AM
Dates	Registration Date	Insert	New Registration		7/7/2022 11:38:06 AM	7/7/2022 11:38 AM
Dates	Signed By Date	Insert	New Registration			7/7/2022 11:38 AM
Dates	Start Date	Insert	New Registration			7/7/2022 11:38 AM
Terminations	Termination Comments	Insert	New Registration			7/7/2022 11:38 AM
Terminations	Termination Date	Insert	New Registration			7/7/2022 11:38 AM
Terminations	Termination Effective Date	Insert	New Registration			7/7/2022 11:38 AM
Terminations	Termination Reason	Insert	New Registration			7/7/2022 11:38 AM