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DSH360066G ST. RITAS MEDICAL CENTER LLC (Terminated)
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Main Details
Name
ST. RITAS MEDICAL CENTER LLC
Subdivision Name
Mercy Health - Putnam County CT - CT
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360066G
Medicare Provider Number
360066
Outpatient Facility Provider Number
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
9/3/2020
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
601 STATE ROUTE 224
OTTAWA, OH 45875
Billing Address
St. Rita's Medical Center LLC
730 W MARKET ST
LIMA, OH 45801
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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