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DSH360064 MERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITAL (ToBeTerminated)
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Main Details
Name
MERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360064
Medicare Provider Number
360064
Additional Details
Current Program Status
ToBeTerminated
Registration Date
10/14/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/2/2022
Last Recertification Date
8/27/2024
Termination Date
Termination Reason
7/1/2025
Change of covered entity type
Contacts
Authorizing Official
Bon Secours Mercy Health
Michelle L Crawford, Market CFO Youngstown
(330) 718-8096
Primary Contact
Bon Secours Mercy Health
Kyle Baluh, Director, 340B Programs
(440) 227-2762
Addresses
Street Address
1044 BELMONT AVENUE
YOUNGSTOWN, OH 44504-1006
Billing Address
ST. ELIZABETH YOUNGSTOWN HOSPITAL
1044 BELMONT AVENUE
YOUNGSTOWN, OH 44504
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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