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HARNESS HEALTH PHARMACY-CENTRAL 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-CENTRAL PHARMACY
Pharmacy Address
DBA HARNESS HEALTH PHARMACY #330
7160 INDUSTRIAL ROW DR STE 330
MASON, OH 45040
Pharmacy Comments
Contract Details
Approval Date
11/6/2024
Contract Begin Date
11/7/2024
Carve-In Effective Date
Contract Comments
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
11/6/2024
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