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CAH361312-00 MERCY HEALTH - URBANA HOSPITAL (Active)
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Main Details
Name
MERCY HEALTH - URBANA HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH361312-00
Medicare Provider Number
361312
Additional Details
Current Program Status
Active
Registration Date
1/5/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/11/2016
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Bon Secours Mercy Health
Jenelle Dee Zelinski, CFO-Springfield Region
(937) 523-5512
Primary Contact
Mercy Health
Joshua Walker, Director of Pharmacy
(937) 523-5301
Addresses
Street Address
904 SCIOTO STREET
URBANA, OH 43078
Billing Address
Mercy Memorial Hospital
904 Scioto Street
Urbana, OH 43078
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/11/16 Participating 9/10/2010 until terminated effective 10/1/2014, reinstated effective 4/1/2016
03/11/2016
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