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PED363306-02 Dayton Children's Hospital (Active)
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Main Details
Name
Dayton Children's Hospital
Subdivision Name
Outpatient Care Center Springboro - Urgent Care at OCCS
Type
Children's Hospital
Rural
No
340B ID
PED363306-02
Medicare Provider Number
363306
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/5/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/7/2017
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Dayton Children's
Benjamin Goodstein, VICE PRESIDENT and Chief Ambulatory Officer
(937) 641-3450
Primary Contact
Dayton Children's
Chad Meyers, Director of Ambulatory Pharmacy Services
(937) 641-4591
Addresses
Street Address
3333 WEST TECH ROAD
Miamisburg, OH 45342-0955
Billing Address
Dayton Children's Hospital
ONE CHILDREN'S PLAZA
DAYTON, OH 45404
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2010, terminated 1/1/2017. Reinstated 1/1/2018.
11/03/2017
April 2025
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