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DSH360012M ST. ANN'S HOSP OF COLUMBUS INC, (Terminated)
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Main Details
Name
ST. ANN'S HOSP OF COLUMBUS INC,
Subdivision Name
MOUNT CARMEL ST. ANN'S-OB CLINIC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360012M
Medicare Provider Number
360012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/9/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/4/2015
Last Recertification Date
9/12/2022
Termination Date
Termination Reason
10/1/2023
Site closure
Contacts
Authorizing Official
Mount Carmel Health System
Nicholas Kreatsoulas, Executive Vice President & Chief Clinical Operations Officer
(614) 546-3266
Primary Contact
Mount Carmel Health System
Terrance John Slavin, Regional Director of Reimbursement
(734) 343-3320
Addresses
Street Address
495 COOPER ROAD
SUITE 420
WESTERVILLE, OH 43081-8056
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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