340B Drug Pricing Program Database
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DSH360259 BAY PARK COMMUNITY HOSPITAL (Active)
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Main Details
Name
BAY PARK COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360259
Medicare Provider Number
360259
Additional Details
Current Program Status
Active
Registration Date
4/10/2023
Participating Start Date
7/1/2023
Participating Approval Date
4/26/2023
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
ProMedica
Andrew James Hageman, Finance Director
(567) 585-0990
Primary Contact
Promedica Health Systems
Devan Matthew Ribley, Lead 340B Analyst
(567) 585-0154
Addresses
Street Address
2801 BAY PARK DRIVE
OREGON, OH 43616
Billing Address
ProMedica Health System
300 N. Summit St
Toledo, OH 43604
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (10/1/2017) until terminated effective date: (07/1/2019), reinstatement effective date: (07/1/2023)
04/13/2023
April 2025
April 2025
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