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CAH361310-00 MERCY HEALTH WILLARD HOSPITAL, LLC (Active)
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Main Details
Name
MERCY HEALTH WILLARD HOSPITAL, LLC
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH361310-00
Medicare Provider Number
361310
Additional Details
Current Program Status
Active
Registration Date
1/28/2011
Participating Start Date
4/1/2011
Participating Approval Date
2/16/2011
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Bon Secours Mercy Health
Emily Wagner, CFO, Mercy Health - Tiffin & Willard
(419) 455-7053
Primary Contact
Mercy Health Willard Hospital
David Gardner, Director of Pharmacy
(419) 455-7147
Addresses
Street Address
1100 NEAL ZICK ROAD
WILLARD, OH 44890
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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