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DSH140158G MERCY HOSPITAL AND MEDICAL CENTER (Terminated)
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Main Details
Name
MERCY HOSPITAL AND MEDICAL CENTER
Subdivision Name
ASHLAND
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140158G
Medicare Provider Number
140158
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/23/2008
Participating Start Date
7/1/2004
Participating Approval Date
4/23/2008
Last Recertification Date
8/6/2015
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
Mercy Hospital and Medical Center
Silia Miglio, VP of Finance
(312) 567-2580
Primary Contact
Mercy Hospital and Medical Center
Steven Silverstein, Pharmacy Health System Director
(312) 567-2489
Addresses
Street Address
3316 S. ASHLAND AVENUE
CHICAGO, IL 60608
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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