340B Drug Pricing Program Database


DSH360064M ST. ELIZABETH HEALTH CENTER (Terminated) - information as of 6/11/2025 7:18:57 PM

Main Details
ST. ELIZABETH HEALTH CENTER
Youngstown Primary Care - Primary Care
Disproportionate Share Hospital
Yes
DSH360064M
360064


Additional Details
Terminated
10/14/2022
1/1/2023
11/2/2022

7/1/2023
Hospital Outpatient facility no longer eligible

Contacts

Bon Secours Mercy Health
Michelle L Crawford, Market CFO Youngstown
(330) 718-8096

Bon Secours Mercy Health
Kyle Baluh, Director, 340B Programs
(440) 227-2762

Addresses

1053 Belmont Avenue
Youngstown, OH 44504

St. Elizabeth Youngstown Inpatient Pharmacy
1044 Belmont Avenue FL 2
Youngstown, OH 44504


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
OH76453381548296106
Shipping Addresses

St. Elizabeth Youngstown Inpatient Pharmacy
1044 Belmont Avenue FL 2
Youngstown, OH 44504
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH360064AChildDSHMERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITALMH-YOUNGST PEDI,WOMEN,SURG,INTER, P - Internal Medicine1001 Covington StreetYoungstownOHToBeTerminated
DSH360064BChildDSHMERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITALMH-YOUNGST PEDI,WOMEN,SURG,INTER, P - Surgery1001 Covington StreetYoungstownOHToBeTerminated
DSH360064CChildDSHMERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITALMH-YOUNGST PEDI,WOMEN,SURG,INTER, P - Pulmonary1001 Covington StreetYoungstownOHToBeTerminated
DSH360064DChildDSHST. ELIZABETH HEALTH CENTERAmbulatory Care Center - Women's Center1001 Covington StreetYoungstownOHTerminated
DSH360064EChildDSHMERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITALAustintown Medical Center - Emergency6252 Mahoning AvenueAustintownOHToBeTerminated
DSH360064FChildDSHMERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITALAustintown Medical Center - MRI6252 Mahoning AvenueAustintownOHToBeTerminated
DSH360064GChildDSHMERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITALAustintown Medical Center - CT6252 Mahoning AvenueAustintownOHToBeTerminated
DSH360064HChildDSHMERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITALAustintown Medical Center - Diagnostic Radiology6252 Mahoning AvenueAustintownOHToBeTerminated
DSH360064JChildDSHMERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITALHeart and Vascular Institute - Poland Cardiac Imaging715 E Western Reserve RoadPolandOHToBeTerminated
DSH360064KChildDSHMERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITALHeart and Vascular Institute - Belmont Youngstown Cardiac Imaging1001 Belmont AvenueYoungstownOHToBeTerminated
DSH360064LChildDSHMERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITALHeart and Vascular Institute - Eastland Warren Cardiac Imaging627 Eastland Avenue SE STE 101WarrenOHToBeTerminated
DSH360064MChildDSHST. ELIZABETH HEALTH CENTERYoungstown Primary Care - Primary Care1053 Belmont AvenueYoungstownOHTerminated
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsPrimary ContactUpdateProfile Change RequestBaluh, Kyle 340B Program Manager Bon Secours Mercy Health 4402272762Baluh, Kyle Director, 340B Programs Bon Secours Mercy Health 440227276211/18/2024 9:38 AM
DetailsStateUpdate To Be TerminatedTerminated7/1/2023 12:01 AM
DatesLast Date That 340B Drugs PurchasedUpdateTermination Request 2/27/2023 12:00:00 AM4/26/2023 11:59 AM
DetailsStateUpdateTermination RequestActiveTo Be Terminated4/26/2023 11:59 AM
TerminationsTermination DateUpdateTermination Request 7/1/2023 12:00:00 AM4/26/2023 11:59 AM
TerminationsTermination Effective DateUpdateTermination Request 2/27/2023 12:00:00 AM4/26/2023 11:59 AM
TerminationsTermination ReasonUpdateTermination Request Hospital Outpatient facility no longer eligible4/26/2023 11:59 AM
DetailsStateUpdate ApprovedActive1/1/2023 12:01 AM
ContactsSigned ByInsertNew Registration Crawford, Michelle L Market CFO Youngstown Bon Secours Mercy Health 330718809611/2/2022 7:19 AM
Details340B IDUpdateNew Registration DSH360064M11/2/2022 7:19 AM
DetailsEntity SubnameUpdateNew RegistrationYoungstown Primary CareYoungstown Primary Care - Primary Care11/2/2022 7:19 AM
DatesParticipating Approval DateUpdateNew Registration 11/2/2022 7:19:44 AM11/2/2022 7:19 AM
DetailsStateUpdateNew RegistrationPendingApproved11/2/2022 7:19 AM
DatesSigned By DateUpdateNew Registration 10/14/2022 1:16:54 PM11/2/2022 7:19 AM
DatesStart DateUpdateNew Registration 1/1/2023 12:00:00 AM11/2/2022 7:19 AM
AddressesMain AddressInsertNew Registration  1053 Belmont Avenue Youngstown, OH 4450410/14/2022 11:13 AM
AddressesBilling AddressInsertNew Registration St. Elizabeth Youngstown Inpatient Pharmacy 1044 Belmont Avenue FL 2 Youngstown, OH 4450410/14/2022 11:13 AM
AddressesShipping AddressInsertNew Registration St. Elizabeth Youngstown Inpatient Pharmacy 1044 Belmont Avenue FL 2 Youngstown, OH 4450410/14/2022 11:13 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False10/14/2022 11:13 AM
Medicaid BillingMedicaid: NumberInsertNew Registration 764533810/14/2022 11:13 AM
Medicaid BillingMedicaid: StateInsertNew Registration OH10/14/2022 11:13 AM
Medicaid BillingNPI: NumberInsertNew Registration 154829610610/14/2022 11:13 AM
Medicaid BillingNPI: StateInsertNew Registration OH10/14/2022 11:13 AM
ContactsPrimary ContactInsertNew Registration Baluh, Kyle 340B Program Manager Bon Secours Mercy Health 440227276210/14/2022 11:13 AM
ContactsAuthorizing OfficialInsertNew Registration Crawford, Michelle L Market CFO Youngstown Bon Secours Mercy Health 330718809610/14/2022 11:13 AM
DetailsAssistance Received From DateInsertNew Registration  10/14/2022 11:13 AM
DetailsAssistance Received To DateInsertNew Registration  10/14/2022 11:13 AM
DetailsLast Recertification DateInsertNew Registration  10/14/2022 11:13 AM
DetailsGrant NumberInsertNew Registration  10/14/2022 11:13 AM
Details340B IDInsertNew Registration  10/14/2022 11:13 AM
DetailsIs Authorizing Official EHB DataInsertNew Registration  10/14/2022 11:13 AM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  10/14/2022 11:13 AM
DetailsMedicare Provider NumberInsertNew Registration 36006410/14/2022 11:13 AM
DetailsEntity NameInsertNew Registration ST. ELIZABETH HEALTH CENTER10/14/2022 11:13 AM
DetailsNOFO NumberInsertNew Registration  10/14/2022 11:13 AM
DetailsProgram CodeInsertNew Registration DSH10/14/2022 11:13 AM
DetailsEntity SubnameInsertNew Registration Youngstown Primary Care10/14/2022 11:13 AM
DatesParticipating Approval DateInsertNew Registration  10/14/2022 11:13 AM
DetailsStateInsertNew Registration Pending10/14/2022 11:13 AM
DatesRegistration DateInsertNew Registration 10/14/2022 11:13:37 AM10/14/2022 11:13 AM
DatesSigned By DateInsertNew Registration  10/14/2022 11:13 AM
DatesStart DateInsertNew Registration  10/14/2022 11:13 AM
TerminationsTermination CommentsInsertNew Registration  10/14/2022 11:13 AM
TerminationsTermination DateInsertNew Registration  10/14/2022 11:13 AM
TerminationsTermination Effective DateInsertNew Registration  10/14/2022 11:13 AM
TerminationsTermination ReasonInsertNew Registration  10/14/2022 11:13 AM