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DSH360025H FIRELANDS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
FIRELANDS REGIONAL MEDICAL CENTER
Subdivision Name
FIRELANDS COUNSELING AND REVOVERY SERVICES
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360025H
Medicare Provider Number
360025
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/1/2016
Last Recertification Date
Termination Date
Termination Reason
1/1/2017
Other
Contacts
Authorizing Official
Firelands Regional Medical Center
Daniel J. Moncher, Executive Vice President & CFO
(419) 557-7793
Primary Contact
Jim Spicer, Assistant Vice President Operations
(419) 557-7340
Addresses
Street Address
76 ASHWOOD DR
TIFFIN, OH 44883-1908
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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