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DSH360035V MOUNT CARMEL HEALTH (Active)
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Main Details
Name
MOUNT CARMEL HEALTH
Subdivision Name
East Enterostomal Therapy Wound Care Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360035V
Medicare Provider Number
360035
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/13/2017
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Mount Carmel Health System
Andrew Rawn Priday, Chief Financial Officer
(614) 546-4146
Primary Contact
Mount Carmel Health System
Terrance John Slavin, Regional Director of Reimbursement
(734) 343-3320
Addresses
Street Address
5965 E Broad St
Suite 120
Columbus, OH 43213-1562
Billing Address
Mount Carmel Health System
3100 Easton Square Place
Suite 300 - Finance
Columbus, OH 43219-6290
Comments
Medicaid Billing
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