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DSH370013U MERCY HOSPITAL OKC (Active)
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Main Details
Name
MERCY HOSPITAL OKC
Subdivision Name
MERCY HOSPITAL OKLAHOMA CITY-SOUTH - Adults and Pediatrics 6 South Medical Surgical
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH370013U
Medicare Provider Number
370013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/12/2023
Participating Start Date
4/1/2023
Participating Approval Date
2/2/2023
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Mercy
Christopher F Hahne, Vice President-Finance
(405) 936-5649
Primary Contact
Mercy Shared Services
Mike Loftus, Director-Hospital Pharmacy
(417) 820-3487
Addresses
Street Address
5200 E I 240 SERVICE RD
OKLAHOMA CITY, OK 73135-2607
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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