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DSH390009A SAINT VINCENT HEALTH CENTER (Active)
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Main Details
Name
SAINT VINCENT HEALTH CENTER
Subdivision Name
SAINT VINCENT SURGERY CENTER OF ERIE
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390009A
Medicare Provider Number
390009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
6/2/2009
Participating Start Date
7/1/2009
Participating Approval Date
6/8/2009
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
SAINT VINCENT HEALTH CENTER
RANDOLPH LEVIS, CFO
(814) 452-5132
Primary Contact
SAINT VINCENT HEALTH CENTER
Rebecca Nick-Dart, Director of Pharmacy
(814) 452-5837
Addresses
Street Address
312 WEST 25TH ST
SAINT VINCENT SURGERY CENTER OF ERIE
ERIE, PA 16502-2624
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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