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DSH360039Y GENESIS HEALTHCARE SYSTEM (Active)
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Main Details
Name
GENESIS HEALTHCARE SYSTEM
Subdivision Name
Genesis Radiology Diagnostic - PET Scan
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360039Y
Medicare Provider Number
360039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/13/2023
Participating Start Date
7/1/2023
Participating Approval Date
5/2/2023
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Genesis Healthcare System
Michael Norman, Chief Financial Officer
(740) 454-4773
Primary Contact
Genesis Healthcare System
Shona Carr, Pharmacy 340b Manager
(740) 455-4900
Addresses
Street Address
2800 Maple Avenue
Zanesville, OH 43701
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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