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DSH360133E Kettering Health Dayton (Active)
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Main Details
Name
Kettering Health Dayton
Subdivision Name
Radiology-Diagnostic 54.00/Radiology 421040
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360133E
Medicare Provider Number
360133
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2013
Participating Start Date
1/1/2014
Participating Approval Date
6/28/2013
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Kettering Health
Harmat Beebe, Vice President Finance Multi-Hospital Campus
(937) 723-3414
Primary Contact
Kettering Health Network:Grandview/Kettering/Ft Hamilton/Sycamore/Soin
Linda McCall, Pharmacy Director
(937) 458-4946
Addresses
Street Address
1997 Miamisburg-Centerville Road
Dayton, OH 45459
Billing Address
Kettering Health A/P
1 Prestige Place
Miamisburg, OH 45342
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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11/25/13 enrolled 7/1/13 thru 9/30/13, not enrolled 10/1/13 thru 12/31/13 due to voluntary withdrawal, re-instated based on new registration submitted in Oct. 2013
11/25/2013
June 2025
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