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HARNESS HEALTH PHARMACY
DSH360112 MERCY HEALTH - ST. VINCENT MEDICAL CENTER
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Covered Entity Details
Entity Name
MERCY HEALTH - ST. VINCENT MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360112
Entity Address
2213 CHERRY STREET
TOLEDO, OH 43608
Medicare Provider Number
360112
Participating Start Date
1/1/2005
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
HARNESS HEALTH PHARMACY
Pharmacy Address
7160 INDUSTRIAL ROW DR STE 331
MASON, OH 45040
Pharmacy Comments
Contract Details
Approval Date
1/10/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/7/2024
Ownership change
Contacts
Covered Entity Signing Official
Michael Whipple, Hospital CFO
(419) 251-6935
Contract Pharmacy Representative
Bon Secours Mercy Health
Behlan Ersoy, System Director Specialty Pharmacy
(513) 557-7661
Signed By Date
1/10/2020
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