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MERCY HEALTH HOME INFUSION - YOUNGSTOWN
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
MERCY HEALTH HOME INFUSION - YOUNGSTOWN
Pharmacy Address
979 TIBBETTS-WICK ROAD
SUITE A
GIRARD, OH 44420
Pharmacy Comments
Contract Details
Approval Date
4/22/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michelle L Crawford, Market CFO Youngstown
(330) 718-8096
Contract Pharmacy Representative
Bon Secours Mercy Health
Lisa Blair, Manager, Pharmacy Operations
(330) 480-4595
Signed By Date
4/11/2025
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