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DSH360134P THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO (Terminated)
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Main Details
Name
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO
Subdivision Name
Good Samaritan Hospital Infusion Center - Western Ridge
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360134P
Medicare Provider Number
360134
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/24/2019
Last Recertification Date
9/8/2020
Termination Date
Termination Reason
4/1/2021
Business decision by the Covered Entity
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
6949 Good Samaritan Dr.
Cincinnati, OH 45247
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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