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DSH360118B MEDCENTRAL HEALTH SYSTEM DBA OHIOHEALTH MANSFIELD HOSPITAL (Active)
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Main Details
Name
MEDCENTRAL HEALTH SYSTEM DBA OHIOHEALTH MANSFIELD HOSPITAL
Subdivision Name
Ontario Freestanding Emergency Department - Emergency Department
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360118B
Medicare Provider Number
360118
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/11/2019
Participating Start Date
4/1/2019
Participating Approval Date
2/19/2019
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
OhioHealth
Curtis L Gingrich, President
(419) 526-8403
Primary Contact
OhioHealh
Eva Brahimaj, Site Manager
(419) 526-8084
Addresses
Street Address
1365 North Lexington-Springmill Road
Ontario, OH 44906
Billing Address
OhioHealth
PO Box 9
Columbus, OH 43216
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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