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DSH360132 Kettering Health Hamilton (Active)
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Main Details
Name
Kettering Health Hamilton
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360132
Medicare Provider Number
360132
Additional Details
Current Program Status
Active
Registration Date
4/15/2013
Participating Start Date
1/1/2014
Participating Approval Date
6/27/2013
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Kettering Health Fort Hamilton Hospital
Steven Chavez, Kettering Health VP Finance and Operations
(937) 762-1644
Primary Contact
Kettering Health Network:Grandview/Kettering/Ft Hamilton/Sycamore/Soin
Linda McCall, Pharmacy Director
(937) 458-4946
Addresses
Street Address
630 Eaton Avenue
Hamilton, OH 45013
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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11/20/13 enrolled 7/1/13 thru 9/30/13, not enrolled 10/1/13 thru 12/31/13 due to inability to meet GPO exclusion requirement, reinstated based on on-line registration submitted in Oct 2013
11/20/2013
April 2025
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