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DSH360012A ST. ANN'S HOSP OF COLUMBUS INC, (Active)
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Main Details
Name
ST. ANN'S HOSP OF COLUMBUS INC,
Subdivision Name
Mount Carmel St. Ann's Medical Outpatient Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360012A
Medicare Provider Number
360012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/9/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/26/2015
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Mount Carmel Health System
Andrew Rawn Priday, Chief Financial Officer
(614) 546-4146
Primary Contact
Mount Carmel Health System
Terrance John Slavin, Regional Director of Reimbursement
(734) 343-3320
Addresses
Street Address
495 COOPER ROAD
SUITE 330
WESTERVILLE, OH 43082
Billing Address
Mount Carmel Health System
3100 Easton Square Place
Suite 300 - Finance
Columbus, OH 43219-6290
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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