Contract Pharmacy Details

HOMEREACH
DSH360017 GRANT MEDICAL CENTER

Entity Name

GRANT MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH360017

Entity Address

111 S Grant Avenue
COLUMBUS, OH 43215

Medicare Provider Number

360017

Participating Start Date

9/9/2005

Last Recertification Date

8/25/2023

Pharmacy Name

HOMEREACH

Pharmacy Address

DBA OHIOHEALTH INFUSION PHARMACY
404 E WILSON BRIDGE RD STE B
WORTHINGTON, OH 43085-2369

Pharmacy Comments

Approval Date

12/4/2012

Contract Begin Date

1/1/2013

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Joe Abel, Controller, Grant Hospital
(614) 544-4112

Signed By Date

10/15/2012

Contract Pharmacy Representative

OhioHealth
Maggie Sherry, Director of Ambulatory Pharmacy Serv
(614) 788-3927