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DSH360236Q CLERMONT MERCY HOSPITAL (Active)
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Main Details
Name
CLERMONT MERCY HOSPITAL
Subdivision Name
MERCY CARE CLINIC - CLERMONT
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360236Q
Medicare Provider Number
360236
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/9/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/3/2023
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
BSMH
Cameron Stockdale, Assistant CFO
(513) 735-7548
Primary Contact
BSMH
Brandon Kyle Cheek, Director of Pharmacy
(513) 732-8670
Addresses
Street Address
3020 Hospital Dr
Suite 230
Batavia, OH 45103
Billing Address
Clermont Mercy Hospital
3000 Hospital Drive
Batavia, OH 45103
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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