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DSH360012S ST. ANN'S HOSP OF COLUMBUS INC, (Terminated)
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Main Details
Name
ST. ANN'S HOSP OF COLUMBUS INC,
Subdivision Name
GI Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360012S
Medicare Provider Number
360012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/10/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/24/2017
Last Recertification Date
8/22/2018
Termination Date
Termination Reason
10/1/2019
Outpatient facility moved within the 4 walls of the parent hospital
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
495 Cooper Road
Suite 411
Westerville, OH 43081
Billing Address
Mount Carmel Health System
6150 East Broad Street
3rd Floor - Finance
Columbus, OH 43213-1574
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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