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HARNESS HEALTH PHARMACY
DSH360161 ST. JOSEPH WARREN HOSPITAL
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Covered Entity Details
Entity Name
ST. JOSEPH WARREN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360161
Entity Address
667 EASTLAND AVENUE SE
WARREN, OH 44484
Medicare Provider Number
360161
Participating Start Date
7/1/2018
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
1/13/2020
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
Anthony Seminaro, CFO, Markets
(941) 587-1220
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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