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RRC360064-00 ST. ELIZABETH HEALTH CENTER (Approved)
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Main Details
Name
ST. ELIZABETH HEALTH CENTER
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC360064-00
Medicare Provider Number
360064
Additional Details
Current Program Status
Approved
Registration Date
4/11/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/22/2025
Last Recertification Date
Contacts
Authorizing Official
Bon Secours Mercy Health
Michelle L Crawford, Market CFO Youngstown
(330) 718-8096
Primary Contact
Bon Secours Mercy Health
Kyle Baluh, Director, 340B Programs
(440) 227-2762
Addresses
Street Address
1044 BELMONT AVENUE
YOUNGSTOWN, OH 44504-1006
Billing Address
ST. ELIZABETH YOUNGSTOWN HOSPITAL
1044 BELMONT AVENUE
YOUNGSTOWN, OH 44504
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (07/01/2024) until terminated effective date: (07/01/2024); reinstatement effective date: (07/01/2025)
04/21/2025
Participating from effective date: (04/01/2017) until terminated effective date: (01/01/2023); reinstatement effective date: (07/01/2024)
04/26/2024
April 2025
April 2025
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