340B Drug Pricing Program Database
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DSH360035DB MOUNT CARMEL HEALTH (Terminated)
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Main Details
Name
MOUNT CARMEL HEALTH
Subdivision Name
Grove City OP Heart Surgery - Heart Surgery
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360035DB
Medicare Provider Number
360035
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
8/24/2022
Participating Start Date
9/13/2022
Participating Approval Date
9/5/2022
Last Recertification Date
8/23/2023
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Mount Carmel Health System
Nicholas Kreatsoulas, Executive Vice President & Chief Clinical Operations Officer
(614) 546-3266
Primary Contact
Mount Carmel Health System
Terrance John Slavin, Regional Director of Reimbursement
(734) 343-3320
Addresses
Street Address
5300 N Meadows Dr.
Suite 120
Grove City, OH 43123
Billing Address
Mount Carmel Health System
3100 Easton Square Place
Suite 300 - Finance
Columbus, OH 43219-6290
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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