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DSH360085AV THE OHIO STATE UNIVERSITY HOSPITAL (Terminated)
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Main Details
Name
THE OHIO STATE UNIVERSITY HOSPITAL
Subdivision Name
OSU Sports Medicine / Sports Medicine PT - Grove City
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360085AV
Medicare Provider Number
360085
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/20/2016
Last Recertification Date
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
The Ohio State University Hospital
Mark Larmore, Chief Financial Officer
(614) 685-9420
Primary Contact
Ohio State University
Robert Joseph Weber, Chief Pharmacy Officer
(614) 293-8470
Addresses
Street Address
3850 Discovery Drive
Grove City, OH 43123
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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