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DSH360066 ST. RITAS MEDICAL CENTER LLC (Terminated)
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Main Details
Name
ST. RITAS MEDICAL CENTER LLC
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360066
Medicare Provider Number
360066
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2019
Participating Start Date
10/1/2019
Participating Approval Date
8/7/2019
Last Recertification Date
9/8/2020
Termination Date
Termination Reason
7/26/2021
Change of hospital entity type
Contacts
Authorizing Official
Mercy Health - St. Rita’s
TIM RIEGER, Regional CFO & VP of Finance
(419) 226-9775
Primary Contact
Mercy Health - St. Rita's
Lisa Brady, Director of Pharmacy
(419) 996-5526
Addresses
Street Address
730 W MARKET ST
LIMA, OH 45801
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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