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CAH361306-01 MERCY ALLEN HOSPITAL (Terminated)
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Main Details
Name
MERCY ALLEN HOSPITAL
Subdivision Name
MERCY ALLEN RURAL HEALTH CLINIC WEL - Rural Health Clinic- Wellington
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH361306-01
Medicare Provider Number
361306
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/18/2017
Last Recertification Date
8/23/2024
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
MercyHealth
Cynthia Dennison, Hospital CFO Lorain
(440) 960-3640
Primary Contact
Mercy Health
Jeffrey Cook, Director of Pharmacy - Mercy Health Lorain and Allen
(440) 960-3144
Addresses
Street Address
840 Patriot Dr
WELLINGTON, OH 44090-1300
Billing Address
Mercy Allen Hospital
200 W. Lorain St.
Oberlin, OH 44074
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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