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RRC360066-00 ST. RITAS MEDICAL CENTER LLC (Active)
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Main Details
Name
ST. RITAS MEDICAL CENTER LLC
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC360066-00
Medicare Provider Number
360066
Additional Details
Current Program Status
Active
Registration Date
7/12/2021
Participating Start Date
7/26/2021
Participating Approval Date
7/22/2021
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
St. Rita's Medical Center LLC
Nicole R Hutchison, CFO
(419) 226-4584
Primary Contact
St. Rita's Medical Center LLC
Kristi Ziegenbusch, Director of Pharmacy
(419) 996-5578
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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