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DSH360236J CLERMONT MERCY HOSPITAL (Active)
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Main Details
Name
CLERMONT MERCY HOSPITAL
Subdivision Name
MH-MT. ORAB MEDICAL CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360236J
Medicare Provider Number
360236
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/2/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/29/2018
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
154 Health Partners Cir
Mt. Orab, OH 45154
Billing Address
Mercy Health Clermont Hospital
3000 Hospital Drive
Batavia, OH 45103
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2016, terminated 7/1/2017. Reinstated 10/1/2018.
08/29/2018
May 2025
May 2025
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