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DSH360035A MOUNT CARMEL HEALTH (Active)
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Main Details
Name
MOUNT CARMEL HEALTH
Subdivision Name
GC GME Family Practice at St. Ann's Hospital
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360035A
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
477 Cooper Rd
Suite 300
Westerville, OH 43081
Billing Address
Mount Carmel Health System
3100 Easton Square Place
Suite 300 - Finance
Columbus, OH 43219-6290
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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