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DSH360159AG ADENA REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
ADENA REGIONAL MEDICAL CENTER
Subdivision Name
ADENA SURGERY CENTER - Outpatient Surgery Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360159AG
Medicare Provider Number
360159
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2022
Participating Start Date
4/1/2022
Participating Approval Date
2/1/2022
Last Recertification Date
8/31/2022
Termination Date
Termination Reason
10/1/2023
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Adena Health System
Katherine Edrington, Chief Operations Officer
(740) 779-7282
Primary Contact
Adena Health System
Fred Yingling, Director of Pharmacy
(740) 779-7648
Addresses
Street Address
4437 STATE ROUTE 159
FL 2
CHILLICOTHE, OH 45601-7065
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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