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DSH360112AG MERCY HEALTH - ST. VINCENT MEDICAL CENTER (Active)
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Main Details
Name
MERCY HEALTH - ST. VINCENT MEDICAL CENTER
Subdivision Name
Mercy Health Franklin Ave Medical Center – OB/GYN - OB/GYN
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360112AG
Medicare Provider Number
360112
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/2/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/12/2017
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Mercy Health - St. Vincent Mercy Medical Center
Michael Whipple, Hospital CFO
(419) 251-6935
Primary Contact
Bon Secours Mercy Health - St Vincent Medical Center
Phillip Nelson, Dir Pharmacy
(419) 251-2540
Addresses
Street Address
2213 Franklin Ave 1st Fl
Toledo, OH 43620
Billing Address
Mercy Health - St Vincent Medical Center
2213 Cherry St
Toledo, OH 43608
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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