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DSH390198 MILLCREEK COMMUNITY HOSPITAL (Active)
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Main Details
Name
MILLCREEK COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390198
Medicare Provider Number
390198
Additional Details
Current Program Status
Active
Registration Date
12/18/2020
Participating Start Date
12/28/2020
Participating Approval Date
12/28/2020
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Millcreek Community Hospital
Marcus Chase Babiak, Chief Operating Officer
(814) 868-7733
Primary Contact
Millcreek Community Hospital
Dawn Moore, Pharmacy Manager
(814) 868-2492
Addresses
Street Address
5515 Peach Street
ERIE, PA 16509
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start 01/01/2016, Termination 01/01/2016, Reinstatement 12/28/2020
12/27/2020
April 2025
April 2025
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