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DSH360039K GENESIS HEALTHCARE SYSTEM (Terminated)
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Main Details
Name
GENESIS HEALTHCARE SYSTEM
Subdivision Name
GENESIS EMERGENCY & TRAUMA SERVICES
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360039K
Medicare Provider Number
360039
Outpatient Facility Provider Number
360039
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/8/2014
Last Recertification Date
8/28/2015
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Genesis Healthcare System
Michael Norman, Chief Financial Officer
(740) 454-4773
Primary Contact
SHANNA PETERSON, PHARMACY PURCHASING MANAGER
(740) 455-7562 Ext: 7562
Addresses
Street Address
800 FOREST AVENUE
ZANESVILLE, OH 43701
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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