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HARNESS HEALTH PHARMACY
DSH360172 Mercy Health- Regional Medical Center LLC
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Covered Entity Details
Entity Name
Mercy Health- Regional Medical Center LLC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360172
Entity Address
3700 Kolbe Road
Lorain, OH 44053
Medicare Provider Number
360172
Participating Start Date
7/1/2014
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
HARNESS HEALTH PHARMACY
Pharmacy Address
7160 INDUSTRIAL ROW DR STE 331
MASON, OH 45040
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
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
Cynthia Dennison, Hospital CFO Lorain
(440) 960-3640
Contract Pharmacy Representative
Bon Secours Mercy Health
Behlan Ersoy, System Director Specialty Pharmacy
(513) 557-7661
Signed By Date
1/13/2020
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