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HARNESS HEALTH PHARMACY-CENTRAL PHARMACY
DSH360112 MERCY HEALTH - ST. VINCENT MEDICAL CENTER
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Covered Entity Details
Entity Name
MERCY HEALTH - ST. VINCENT MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360112
Entity Address
2213 CHERRY STREET
TOLEDO, OH 43608
Medicare Provider Number
360112
Participating Start Date
1/1/2005
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
HARNESS HEALTH PHARMACY-CENTRAL PHARMACY
Pharmacy Address
DBA HARNESS HEALTH PHARMACY #330
7160 INDUSTRIAL ROW DR STE 330
MASON, OH 45040
Pharmacy Comments
Contract Details
Approval Date
11/5/2024
Contract Begin Date
11/7/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Whipple, Hospital CFO
(419) 251-6935
Contract Pharmacy Representative
Harness Health Pharmacy
Brent Kovalyak, System Director of Pharmacy Operations
(513) 305-6835
Signed By Date
11/5/2024
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