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HARNESS HEALTH PHARMACY
DSH360086 SPRINGFIELD REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
SPRINGFIELD REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360086
Entity Address
100 MEDICAL CENTER DRIVE
SPRINGFIELD, OH 45504-2687
Medicare Provider Number
360086
Participating Start Date
4/1/2016
Last Recertification Date
8/22/2024
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
Jenelle Dee Zelinski, CFO-Springfield Region
(937) 523-5512
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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