340B Drug Pricing Program Database
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DSH360054DN HOLZER (Active)
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Main Details
Name
HOLZER
Subdivision Name
HOLZER - Holzer Meigs Emergency Department
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360054DN
Medicare Provider Number
360054
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/4/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/10/2017
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Holzer
Michael P Haynes, EVP/CFO
(740) 446-5743
Primary Contact
Holzer
Mary Ann Clemente, 340B Compliance Analyst
(740) 446-5803
Addresses
Street Address
41861 POMEROY PIKE
POMEROY, OH 45769-9473
Billing Address
Holzer Hospital Foundation
100 Jackson Pike
Gallipolis, OH 45631
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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