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DSH360012AE ST. ANN'S HOSP OF COLUMBUS INC, (Active)
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Main Details
Name
ST. ANN'S HOSP OF COLUMBUS INC,
Subdivision Name
MOUNT CARMEL ST. ANN'S RADIATION THERAPY - RADIATION THERAPY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360012AE
Medicare Provider Number
360012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/6/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/20/2018
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Mount Carmel Health System
Andrew Rawn Priday, Chief Financial Officer
(614) 546-4146
Primary Contact
Mount Carmel Health System
Terrance John Slavin, Regional Director of Reimbursement
(734) 343-3320
Addresses
Street Address
495 COOPER ROAD
SUITE 120
WESTERVILLE, OH 43081
Billing Address
MOUNT CARMEL HEALTH SYSTEM
3100 Easton Square Place
Suite 300 - Finance
Columbus, OH 43219-6290
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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