340B Drug Pricing Program Database
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DSH360076AD ATRIUM MEDICAL CENTER (Active)
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Main Details
Name
ATRIUM MEDICAL CENTER
Subdivision Name
AMC HEART FAILURE CLINIC - CARDIOLOGY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360076AD
Medicare Provider Number
360076
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/13/2023
Participating Start Date
10/1/2023
Participating Approval Date
8/1/2023
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Premier Health
Craig Allen Ganger, Chief Financial Officer
(937) 499-9988
Primary Contact
Premier Health
SHELLY STIDHAM, 340B Coordinator
(937) 838-5767
Addresses
Street Address
1 MEDICAL CENTER DRIVE
200
MIDDLETOWN, OH 45005
Billing Address
PREMIER HEALTH
110 N MAIN STREET
DAYTON, OH 45402
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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