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DSH360085HM THE OHIO STATE UNIVERSITY HOSPITAL (Terminated)
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Main Details
Name
THE OHIO STATE UNIVERSITY HOSPITAL
Subdivision Name
OPHTHALMOLOGY OCULOPLASTICS COUNTY LINE - OPHTHALMOLOGY WESTERVILLE
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360085HM
Medicare Provider Number
360085
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2021
Participating Start Date
4/1/2021
Participating Approval Date
2/26/2021
Last Recertification Date
9/16/2022
Termination Date
Termination Reason
1/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
The Ohio State University Hospital
Vincent P Tammaro, Chief Financial Officer
(614) 685-9420
Primary Contact
OSU Med Center
Trisha A Jordan, Chief Pharmacy Officer
(614) 293-9097
Addresses
Street Address
484 County Line Rd W
Suite 240
Westerville, OH 43082
Billing Address
OSUMC Accounts Payable Department
660 Ackerman Rd.
PO Box 183104
Columbus, OH 43218-3104
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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