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DSH360134AH THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO (Active)
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Main Details
Name
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO
Subdivision Name
GOOD SAMARITAN WEIGHT MGMT MONTGOME - Weight Management
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360134AH
Medicare Provider Number
360134
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2025
Participating Start Date
4/1/2025
Participating Approval Date
3/11/2025
Last Recertification Date
Contacts
Authorizing Official
The Good Samaritan Hospital of Cincinnati Ohio
Michael Crofton, Sr. Vice President & CFO
(513) 569-6577
Primary Contact
The Good Samaritan Hospital of Cincinnati Ohio
Greg Nocito, Director of Pharmacy Operations
(513) 865-1495
Addresses
Street Address
10496 MONTGOMERY RD
STE 201
MONTGOMERY, OH 45242-5220
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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