340B Drug Pricing Program Database
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DSH360236 CLERMONT MERCY HOSPITAL (Active)
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Main Details
Name
CLERMONT MERCY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360236
Medicare Provider Number
360236
Additional Details
Current Program Status
Active
Registration Date
4/5/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/10/2018
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
BSMH
Cameron Stockdale, Assistant CFO
(513) 735-7548
Primary Contact
BSMH
Brandon Kyle Cheek, Director of Pharmacy
(513) 732-8670
Addresses
Street Address
3000 HOSPITAL DRIVE
BATAVIA, OH 45103
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date (4/1/2016) until terminated effective date (7/1/2017), reinstatement date effective (07/01/2018)
04/06/2018
03/03/11 DOC RECD TO CONFIRM ELIG DSH ADJ %
03/03/2011
May 2025
May 2025
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