340B Drug Pricing Program Database
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DSH360051DB MIAMI VALLEY HOSPITAL (Active)
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Main Details
Name
MIAMI VALLEY HOSPITAL
Subdivision Name
Miami Valley Hospital North - SNSC Surgery and Recovery - Ambulatory Surgery
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360051DB
Medicare Provider Number
360051
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/11/2021
Participating Start Date
4/1/2021
Participating Approval Date
2/17/2021
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Premier Health
Craig Allen Ganger, Chief Financial Officer
(937) 499-9988
Primary Contact
Premier Health
SHELLY STIDHAM, 340B Coordinator
(937) 838-5767
Addresses
Street Address
9000 North Main Street
Dayton, OH 45415
Billing Address
Premier Health
110 North Main Street
Dayton, OH 45402
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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