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DSH360012Q ST. ANN'S HOSP OF COLUMBUS INC, (Terminated)
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Main Details
Name
ST. ANN'S HOSP OF COLUMBUS INC,
Subdivision Name
Lewis Center Diabetes Self Mgmt Ed
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360012Q
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
9/14/2022
Termination Date
Termination Reason
10/1/2023
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
7100 Graphics Way
Suite 1500
Lewis Center, OH 43035
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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June 2025
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