340B Drug Pricing Program Database
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DSH360159AD ADENA REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
ADENA REGIONAL MEDICAL CENTER
Subdivision Name
Adena Interventional Pain Management
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360159AD
Medicare Provider Number
360159
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/9/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/17/2015
Last Recertification Date
9/1/2016
Termination Date
Termination Reason
1/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Adena Health System
Lisa Marie Carlson, CFO
(740) 779-7582
Primary Contact
Adena Health System
Fred Yingling, Director of Pharmacy
(740) 779-7648
Addresses
Street Address
4437 St. Rt. 159, Suite G15
Chillicothe, OH 45601
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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