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DSH390028 UPMC MERCY (Active)
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Main Details
Name
UPMC MERCY
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390028
Medicare Provider Number
390028
Additional Details
Current Program Status
Active
Registration Date
11/23/2005
Participating Start Date
9/2/2008
Participating Approval Date
9/2/2008
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
UPMC
Jonathan Petrie, CFO UPMC Magee and Mercy
(412) 578-9416
Primary Contact
UPMC Mercy
Sandra Elizabeth Nickman, Pharmacy, Director
(724) 396-8449
Addresses
Street Address
1400 LOCUST STREET
PITTSBURGH, PA 15219
Billing Address
PROCUREMENT: H C PHARMACY CENTRAL
3175 EAST CARSON ST.
PITTSBURGH, PA 15203
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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9/1/09-DOC RECD TO CONFIRM ELIG DSH ADJ %; 9/17/08-ADDED BILL&SHIPPING ADDRESS; ORIG PART FROM 11/25/05 TO 3/31/08, NOT ELIG FROM 4/1/08 THRU 9/1/08, 9/2/08 NAME CHANGE (WAS PITTSBURGH MERCY HEALTH SYSTEM), MED # CHANGE (WAS 1001380890042)
11/18/2009
April 2025
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