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HARNESS HEALTH PHARMACY-CENTRAL PHARMACY
DSH360064 MERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITAL
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Covered Entity Details
Entity Name
MERCY HEALTH - ST. ELIZABETH YOUNGSTOWN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360064
Entity Address
1044 BELMONT AVENUE
YOUNGSTOWN, OH 44504-1006
Medicare Provider Number
360064
Participating Start Date
1/1/2023
Last Recertification Date
8/27/2024
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
HARNESS HEALTH PHARMACY-CENTRAL PHARMACY
Pharmacy Address
DBA HARNESS HEALTH PHARMACY #331
7160 INDUSTRIAL ROW DR STE 331
MASON, OH 45040
Pharmacy Comments
Contract Details
Approval Date
11/6/2024
Contract Begin Date
11/7/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Michelle L Crawford, Market CFO Youngstown
(330) 718-8096
Contract Pharmacy Representative
Harness Health Pharmacy
Behlan Ersoy, System Director Specialty Pharmacy
(513) 557-7661
Signed By Date
11/6/2024
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