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DSH360039M GENESIS HEALTHCARE SYSTEM (Terminated)
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Main Details
Name
GENESIS HEALTHCARE SYSTEM
Subdivision Name
GENESIS WOUND CARE CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360039M
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
7/1/2016
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
945 BETHESDA DRIVE
ZANESVILLE, OH 43701
Billing Address
GENESIS HEALTHCARE SYSTEM
2800 MAPLE AVE
ZANESVILLE, OH 43701
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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