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DSH360035BL MOUNT CARMEL HEALTH (Terminated)
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Main Details
Name
MOUNT CARMEL HEALTH
Subdivision Name
ANTICOAGULATION CENTER - Anticoagulation Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360035BL
Medicare Provider Number
360035
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/9/2019
Participating Start Date
4/1/2019
Participating Approval Date
2/25/2019
Last Recertification Date
8/20/2019
Termination Date
Termination Reason
10/1/2020
Site closure
Contacts
Authorizing Official
Mount Carmel Health System
Nicholas Kreatsoulas, Executive Vice President & Chief Clinical Operations Officer
(614) 546-3266
Primary Contact
St. Ann's Hospital
Steve Ware, Reimbursement Manager
(614) 546-3290
Addresses
Street Address
4674 BRITTON PKWY
STE 2150
HILLIARD, OH 43026-9825
Billing Address
Mount Carmel Health System
6150 East Broad Street
3rd Floor - Finance
Columbus, OH 43213-1574
Comments
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