340B Drug Pricing Program Database
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DSH360051DR MIAMI VALLEY HOSPITAL (Active)
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Main Details
Name
MIAMI VALLEY HOSPITAL
Subdivision Name
Miami Valley Hospital South - Neuro Infusion - Infusion
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360051DR
Medicare Provider Number
360051
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2024
Participating Start Date
10/1/2024
Participating Approval Date
8/1/2024
Last Recertification Date
Contacts
Authorizing Official
Premier Health
Craig Allen Ganger, Chief Financial Officer
(937) 499-9988
Primary Contact
Premier Health
SHELLY STIDHAM, 340B Coordinator
(937) 838-5767
Addresses
Street Address
2300 Miami Valley Drive
Suite 260
Centerville, OH 45459
Billing Address
Miami Valley Hospital
110 N Main St
Attn Accts Payable
Dayton, OH 45402
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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