340B Drug Pricing Program Database
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DSH360133M GRANDVIEW HOSPITAL (Terminated)
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Main Details
Name
GRANDVIEW HOSPITAL
Subdivision Name
GRANDVIEW BOONSHOFT INFUSION CENTER / Women's Cancer Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360133M
Medicare Provider Number
360133
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/8/2014
Last Recertification Date
11/6/2017
Termination Date
Termination Reason
10/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Fort Hamilton Hospital/Grandview Medical Center/Southview Medical Center/Sycamore Medical Center
William E Villegas, Regional VP of Finance
(937) 723-3414
Primary Contact
Grandview Hospital
Linda McCall, Director Pharmacy
(937) 723-5816
Addresses
Street Address
3737 SOUTHERN BLVD
KETTERING, OH 45421-1262
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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