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DSH390009C SAINT VINCENT HEALTH CENTER (Active)
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Main Details
Name
SAINT VINCENT HEALTH CENTER
Subdivision Name
Hardner Building-Cardio Tech Services / Heart Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390009C
Medicare Provider Number
390009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/6/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/12/2016
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
SAINT VINCENT HEALTH CENTER
RANDOLPH LEVIS, CFO
(814) 452-5132
Primary Contact
SAINT VINCENT HEALTH CENTER
Rebecca Nick-Dart, Director of Pharmacy
(814) 452-5837
Addresses
Street Address
2315 MYRTLE STREET
STE G10
Erie, PA 16502-4602
Billing Address
Saint Vincent Health Center
232 WEST 25TH Street
Erie, PA 16544-0002
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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