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DSH360039N GENESIS HEALTHCARE SYSTEM (Terminated)
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Main Details
Name
GENESIS HEALTHCARE SYSTEM
Subdivision Name
GENESIS PERIOPERATIVE SERVICES
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360039N
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
Genesis-Good Samaritan
ZANESVILLE, OH 43701
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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