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DSH360035AC MOUNT CARMEL HEALTH (Terminated)
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Main Details
Name
MOUNT CARMEL HEALTH
Subdivision Name
Anticoagulation Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360035AC
Medicare Provider Number
360035
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/10/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/13/2017
Last Recertification Date
8/20/2019
Termination Date
Termination Reason
10/1/2020
Site closure
Contacts
Authorizing Official
Mount Carmel Health System
Nicholas Kreatsoulas, Executive Vice President & Chief Clinical Operations Officer
(614) 546-3266
Primary Contact
St. Ann's Hospital
Steve Ware, Reimbursement Manager
(614) 546-3290
Addresses
Street Address
730 West Rich Street
Columbus, OH 43222-1620
Billing Address
Mount Carmel Health System
6150 E Broad St
3rd Floor Finance
Columbus, OH 43213
Comments
Medicaid Billing
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Contract Pharmacies
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