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DSH360134Q THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO (Active)
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Main Details
Name
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO
Subdivision Name
Good Samaritan Infusion Center Thomas Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360134Q
Medicare Provider Number
360134
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/29/2019
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
The Good Samaritan Hospital of Cincinnati Ohio
Michael Crofton, Sr. Vice President & CFO
(513) 569-6577
Primary Contact
The Good Samaritan Hospital of Cincinnati Ohio
Greg Nocito, Director of Pharmacy Operations
(513) 865-1495
Addresses
Street Address
10506 Montgomery Rd
Suite A
Cincinnati, OH 45242-4487
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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