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DSH360134Z THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO (Active)
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Main Details
Name
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO
Subdivision Name
GOOD SAMARITAN INFECTIOUS DISEASE C - Good Samaritan Hospital Infectious Disease-MOB
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360134Z
Medicare Provider Number
360134
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2022
Participating Start Date
7/1/2022
Participating Approval Date
6/10/2022
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
The Good Samaritan Hospital of Cincinnati Ohio
Michael Crofton, Sr. Vice President & CFO
(513) 569-6577
Primary Contact
The Good Samaritan Hospital of Cincinnati Ohio
Greg Nocito, Director of Pharmacy Operations
(513) 865-1495
Addresses
Street Address
3219 CLIFTON AVE
STE 225
CINCINNATI, OH 45220-3047
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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