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HARNESS HEALTH PHARMACY
RRC360064-00 ST. ELIZABETH HEALTH CENTER
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Covered Entity Details
Entity Name
ST. ELIZABETH HEALTH CENTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC360064-00
Entity Address
1044 BELMONT AVENUE
YOUNGSTOWN, OH 44504-1006
Medicare Provider Number
360064
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
HARNESS HEALTH PHARMACY
Pharmacy Address
7160 INDUSTRIAL ROW DR
SUITE 330
MASON, OH 45040
Pharmacy Comments
Contract Details
Approval Date
4/30/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Michelle L Crawford, Market CFO Youngstown
(330) 718-8096
Contract Pharmacy Representative
Harness Health Pharmacy
Brent Kovalyak, System Director of Pharmacy Operations
(513) 305-6835
Signed By Date
4/15/2024
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