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DSH360035F MOUNT CARMEL HEALTH (Terminated)
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Main Details
Name
MOUNT CARMEL HEALTH
Subdivision Name
West Heart Failure & Structural Heart
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360035F
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
8/25/2021
Termination Date
Termination Reason
10/1/2022
Site closure
Contacts
Authorizing Official
Mount Carmel Health System
Nicholas Kreatsoulas, Executive Vice President & Chief Clinical Operations Officer
(614) 546-3266
Primary Contact
Mount Carmel Health System
Terrance John Slavin, Regional Director of Reimbursement
(734) 343-3320
Addresses
Street Address
730 West Rich St
Columbus, OH 43222-1620
Billing Address
Mount Carmel Health System
6150 E Broad St
3rd Floor Finance
Columbus, OH 43213-1574
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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