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HARNESS HEALTH PHARMACY-CENTRAL PHARMACY
DSH360236 CLERMONT MERCY HOSPITAL
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Covered Entity Details
Entity Name
CLERMONT MERCY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360236
Entity Address
3000 HOSPITAL DRIVE
BATAVIA, OH 45103
Medicare Provider Number
360236
Participating Start Date
7/1/2018
Last Recertification Date
8/29/2024
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
Contacts
Covered Entity Signing Official
Shiley K Harper, CFO
(513) 205-0202
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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