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DSH360076K ATRIUM MEDICAL CENTER (Terminated)
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Main Details
Name
ATRIUM MEDICAL CENTER
Subdivision Name
ATRIUM HEALTH CENTER MASON / Lab
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360076K
Medicare Provider Number
360076
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/24/2017
Last Recertification Date
8/31/2018
Termination Date
Termination Reason
4/1/2019
Site closure
Contacts
Authorizing Official
Premier Health
Scott Andrew Shelton, VP CFO
(937) 499-9989
Primary Contact
Premier Health
Jennifer Marie Ranly, Director, Reimbursement
(937) 499-5529
Addresses
Street Address
7450S MASON MONTGOMERY RD
MASON, OH 45040-7802
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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