Covered Entity Details

DSH360020C SUMMA HEALTH SYSTEM (Active) - information as of 4/29/2025 1:43:28 AM

Main Details

Name

SUMMA HEALTH SYSTEM

Subdivision Name

Richard M. and Yvonne Hamlin Pavilion / Endoscopy

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH360020C

Medicare Provider Number

360020

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/10/2017

Participating Start Date

10/1/2017

Participating Approval Date

7/13/2017

Last Recertification Date

8/14/2024

Contacts

Authorizing Official

Summa Health
Thomas Clifford Deveny, President and CEO
(234) 312-5050

Primary Contact

Summa Health
John Feucht II, Vice President, Pharmacy Services
(330) 375-4397

Addresses

Street Address

95 Arch St.
Suite G55
Akron, OH 44304

Billing Address

Summa Health
1077 Gorge Blvd.
Akron, OH 44310

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
OH	0227833	1396765681

Shipping Addresses

Shipping Address 1

Summa Health System
Pharmacy
525 E. Market St.
Akron, OH 44304-2090

Shipping Address 2

Summa Health Retail Pharmacy
Akron Campus
525 East Market Street
Akron, OH 44304

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH360020A	Child	DSH	SUMMA HEALTH SYSTEM	JEAN B MILTON N COOPER CANCER CENTER	161 N. FORGE ST	AKRON	OH	Active
DSH360020AA	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Pulmonary Function Testing	155 5th St. NE	Barberton	OH	Active
DSH360020AB	Child	DSH	SUMMA HEALTH SYSTEM	St. Thomas Campus / Respiratory Care	444 N Main St	Akron	OH	Terminated
DSH360020AC	Child	DSH	SUMMA HEALTH SYSTEM	Richard M. and Yvonne Hamlin Pavilion / Pulmonary Function Testing	95 Arch St.	Akron	OH	Active
DSH360020AD	Child	DSH	SUMMA HEALTH SYSTEM	Wadsworth-Rittman Medical Center / Respiratory Care	195 Wadsworth Rd.	Wadsworth	OH	Active
DSH360020AE	Child	DSH	SUMMA HEALTH SYSTEM	Medina Medical Center - Medina / Pulmonary Function Testing	3780 Medina Road	Medina	OH	Active
DSH360020AF	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Cardiac Stress Testing	155 5th St. NE	Barberton	OH	Active
DSH360020AG	Child	DSH	SUMMA HEALTH SYSTEM	Richard M. and Yvonne Hamlin Pavilion / Noninvasive Cardio Service	95 Arch St.	Akron	OH	Active
DSH360020AH	Child	DSH	SUMMA HEALTH SYSTEM	Wadsworth-Rittman Medical Center / Cardiovascular Testing Services	195 Wadsworth Rd.	Wadsworth	OH	Active
DSH360020AJ	Child	DSH	SUMMA HEALTH SYSTEM	Richard M. and Yvonne Hamlin Pavilion / Noninvasive Vascular	95 Arch St.	Akron	OH	Active
DSH360020AK	Child	DSH	SUMMA HEALTH SYSTEM	Medina Medical Center - Medina / Outpatient Oncology	3780 Medina Road	Medina	OH	Active
DSH360020AL	Child	DSH	SUMMA HEALTH SYSTEM	East Pavilion / Ophthalmology Clinic	75 Arch St.	Akron	OH	Active
DSH360020AM	Child	DSH	SUMMA HEALTH SYSTEM	Summa Health at Green Family YMCA - Green / Diagnostic Imaging	3838 Massillon Road	Uniontown	OH	Active
DSH360020AN	Child	DSH	SUMMA HEALTH SYSTEM	White Pond Medical Center - White Pond / Imaging	1 Park West Blvd.	Akron	OH	Active
DSH360020AP	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Center for Corporate Health	155 5th St. NE	Barberton	OH	Active
DSH360020AQ	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Outpatient Oncology	155 5th St. NE	Barberton	OH	Active
DSH360020AR	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Family Practice Center	155 5th St. NE	Barberton	OH	Active
DSH360020AS	Child	DSH	SUMMA HEALTH SYSTEM	Green Medical Center / Center for Corporate Health	1835 Franks Parkway	Uniontown	OH	Active
DSH360020AT	Child	DSH	SUMMA HEALTH SYSTEM	Cuyahoga Falls Medical Center / Center for Corporate Health	1860 State Road	Cuyahoga Falls	OH	Active
DSH360020AU	Child	DSH	SUMMA HEALTH SYSTEM	Wound Care Center	623 East Market Street	Akron	OH	Active
DSH360020AV	Child	DSH	SUMMA HEALTH SYSTEM	South Pavilion / Internal Medicine	55 Arch St	Akron	OH	Active
DSH360020AW	Child	DSH	SUMMA HEALTH SYSTEM	South Pavilion / Family Practice Center	55 Arch Street	Akron	OH	Active
DSH360020AX	Child	DSH	SUMMA HEALTH SYSTEM	East Pavilion / Care Center	75 Arch St.	Akron	OH	Active
DSH360020AY	Child	DSH	SUMMA HEALTH SYSTEM	East Pavilion / Center for Senior Health	75 Arch St.	Akron	OH	Active
DSH360020AZ	Child	DSH	SUMMA HEALTH SYSTEM	Richard M. and Yvonne Hamlin Pavilion / Bariatric Care	95 Arch St.	Akron	OH	Active
DSH360020B	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Endoscopy	155 5TH STREET NE	BARBERTON	OH	Active
DSH360020BA	Child	DSH	SUMMA HEALTH SYSTEM	Wadsworth-Rittman Medical Center / Center for Corporate Health	195 Wadsworth Rd.	Wadsworth	OH	Active
DSH360020BB	Child	DSH	SUMMA HEALTH SYSTEM	Wadsworth-Rittman Medical Center / Emergency Dept	195 Wadsworth Rd.	Wadsworth	OH	Active
DSH360020BC	Child	DSH	SUMMA HEALTH SYSTEM	Green Emergency Department	1825 Franks Parkway	Uniontown	OH	Active
DSH360020BD	Child	DSH	SUMMA HEALTH SYSTEM	Medina Medical Center -Medina / Emergency Department	3780 Medina Road	Medina	OH	Terminated
DSH360020BE	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus/Labor and Delivery - OB	155 5th Street NE	Barberton	OH	Active
DSH360020BF	Child	DSH	SUMMA HEALTH SYSTEM	Wadsworth-Rittman Medical Center Operating Room - Surgery	195 Wadsworth Road	Wadsworth	OH	Active
DSH360020BG	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus/Sameday Surgery Center - Surgery	155 5th Street NE	Barberton	OH	Active
DSH360020BH	Child	DSH	SUMMA HEALTH SYSTEM	Psych Intensive OP Therapy	45 Arch Street	Akron	OH	Active
DSH360020BJ	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus/Emergency Department - Emergency Department	155 5th Street NE	Barberton	OH	Active
DSH360020BK	Child	DSH	SUMMA HEALTH SYSTEM	Traumatic Stress Center	45 Arch Street	Akron	OH	Active
DSH360020BL	Child	DSH	SUMMA HEALTH SYSTEM	Wadsworth Rittman Medical Center/Same Day Surgery - Same Day Surgery	195 Wadsworth Road	Wadsworth	OH	Active
DSH360020BM	Child	DSH	SUMMA HEALTH SYSTEM	Canton-Ignatia Hall - Psych	3730 Whipple Ave NW	Canton	OH	Terminated
DSH360020BN	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus Operating Room - Surgery	155 5th Street NE	Barberton	OH	Active
DSH360020BP	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus/Cath Lab - Cardiac Cath Lab	155 5th Street NE	Barberton	OH	Active
DSH360020BQ	Child	DSH	SUMMA HEALTH SYSTEM	Hudson Medical Center-Psych Services - Psych Clinic	1305 Corporate Drive	Hudson	OH	Active
DSH360020BR	Child	DSH	SUMMA HEALTH SYSTEM	Hudson-Chemical Dependency Intensive OP - Chemical Dependency Intensive OP Therapy	5655 Hudson Drive	Hudson	OH	Active
DSH360020BS	Child	DSH	SUMMA HEALTH SYSTEM	St. Thomas Campus/MRI - Radiology-MRI	444 N Main Street	Akron	OH	Terminated
DSH360020BT	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus/Outpatient Clinic - Outpatient Clinic	155 5th Street NE	Barberton	OH	Active
DSH360020BU	Child	DSH	SUMMA HEALTH SYSTEM	Intensive Outpatient Therapy - Intensive OP Therapy	45 Arch Street	Akron	OH	Active
DSH360020BV	Child	DSH	SUMMA HEALTH SYSTEM	Non-invasive Cardiology/Stress Lab - Cardiology	1 Park West	Akron	OH	Active
DSH360020BW	Child	DSH	SUMMA HEALTH SYSTEM	Block Center - Block Center (ECT)	45 Arch Street	Akron	OH	Active
DSH360020C	Child	DSH	SUMMA HEALTH SYSTEM	Richard M. and Yvonne Hamlin Pavilion / Endoscopy	95 Arch St.	Akron	OH	Active
DSH360020D	Child	DSH	SUMMA HEALTH SYSTEM	Wadsworth-Rittman Medical Center / Endoscopy	195 Wadsworth Rd.	Wadsworth	OH	Active
DSH360020E	Child	DSH	SUMMA HEALTH SYSTEM	East Pavilion / Maternal Fetal Medicine	75 Arch St.	Akron	OH	Active
DSH360020F	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Breast Center	155 5th St. NE	Barberton	OH	Active
DSH360020G	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Diagnostic Radiology	155 5th St. NE	Barberton	OH	Active
DSH360020H	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Angiography	155 5th St. NE	Barberton	OH	Active
DSH360020J	Child	DSH	SUMMA HEALTH SYSTEM	Green Medical Center / Imaging	1835 Franks Parkway	Uniontown	OH	Active
DSH360020K	Child	DSH	SUMMA HEALTH SYSTEM	St. Thomas Campus / Diagnostic Radiology	444 N Main St	Akron	OH	Terminated
DSH360020L	Child	DSH	SUMMA HEALTH SYSTEM	Hudson Medical Center / Hudson Imaging	5655 Hudson Drive	Hudson	OH	Active
DSH360020M	Child	DSH	SUMMA HEALTH SYSTEM	Richard M. and Yvonne Hamlin Pavilion / Breast Center	95 Arch St.	Akron	OH	Active
DSH360020N	Child	DSH	SUMMA HEALTH SYSTEM	Richard M. and Yvonne Hamlin Pavilion / OP Diagnostic Center	95 Arch St.	Akron	OH	Active
DSH360020P	Child	DSH	SUMMA HEALTH SYSTEM	Wadsworth-Rittman Medical Center / Breast Center	195 Wadsworth Rd.	Wadsworth	OH	Active
DSH360020Q	Child	DSH	SUMMA HEALTH SYSTEM	Medina Medical Center / Medina Imaging	3780 Medina Road	Medina	OH	Active
DSH360020R	Child	DSH	SUMMA HEALTH SYSTEM	Wadsworth-Rittman Medical Center / Nuclear Medicine	195 Wadsworth Rd.	Wadsworth	OH	Active
DSH360020S	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / CT Scan	155 5th St. NE	Barberton	OH	Active
DSH360020T	Child	DSH	SUMMA HEALTH SYSTEM	St. Thomas Campus / CT Scan	444 N Main St	Akron	OH	Terminated
DSH360020U	Child	DSH	SUMMA HEALTH SYSTEM	Wadsworth-Rittman Medical Center / CT Scan	195 Wadsworth Rd.	Wadsworth	OH	Active
DSH360020V	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Magnetic Resonance Imaging	155 5th St. NE	Barberton	OH	Active
DSH360020W	Child	DSH	SUMMA HEALTH SYSTEM	Wadsworth-Rittman Medical Center / Magnetic Resonance Imaging	195 Wadsworth Rd.	Wadsworth	OH	Active
DSH360020X	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Multidisciplinary Interventional Lab	155 5th St. NE	Barberton	OH	Active
DSH360020Y	Child	DSH	SUMMA HEALTH SYSTEM	Richard M. and Yvonne Hamlin Pavilion / Anti-Coagulation Management Clinic	95 Arch St.	Akron	OH	Active
DSH360020Z	Child	DSH	SUMMA HEALTH SYSTEM	Barberton Campus / Respiratory Care	155 5th St. NE	Barberton	OH	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/27/2023 1:56:47 PM	8/14/2024 5:17:03 PM	8/14/2024 5:17 PM
Details	Last Recertification Date	Update	Recertification	9/14/2022 12:32:09 AM	8/27/2023 1:56:47 PM	8/27/2023 1:56 PM
Details	Last Recertification Date	Update	Recertification	8/23/2021 11:31:40 AM	9/14/2022 12:32:09 AM	9/14/2022 12:32 AM
Details	Last Recertification Date	Update	Recertification	9/4/2020 12:25:09 PM	8/23/2021 11:31:40 AM	8/23/2021 11:31 AM
Addresses	Shipping Address	Insert	Change Request		Summa Health Retail Pharmacy Akron Campus 525 East Market Street Akron, OH 44304	1/26/2021 10:27 AM
Addresses	Billing Address	Update	Recertification	Summa Health - Summa Center 168 E. Market Street P.O. Box 2090 Akron, OH 44309-2090	Summa Health 1077 Gorge Blvd. Akron, OH 44310	9/4/2020 12:25 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1396765681	9/4/2020 12:25 PM
Medicaid Billing	NPI: State	Insert	Recertification		OH	9/4/2020 12:25 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1396765681 ( )		9/4/2020 12:25 PM
Details	Last Recertification Date	Update	Recertification	8/21/2019 10:22:44 AM	9/4/2020 12:25:09 PM	9/4/2020 12:25 PM
Contacts	Primary Contact	Update	Profile Change Request	Feucht II, John System Director, Pharmacy Services Summa Health 3303754397	Feucht II, John Vice President, Pharmacy Services Summa Health 3303754397	8/12/2020 2:20 PM
Contacts	Authorizing Official	Update	Profile Change Request	Deveny, Thomas Clifford Interim President and CEO Summa Health 2343125051	Deveny, Thomas Clifford President and CEO Summa Health 2343125050	8/10/2020 2:32 PM
Contacts	Signed By	Update	Profile Change Request	Deveny, Thomas Clifford Interim President and CEO Summa Health 2343125051	Deveny, Thomas Clifford President and CEO Summa Health 2343125050	8/10/2020 2:32 PM
Details	Last Recertification Date	Update	Recertification	8/20/2018 5:28:09 PM	8/21/2019 10:22:44 AM	8/21/2019 10:22 AM
Details	Last Recertification Date	Update	Recertification	11/6/2017 10:47:20 AM	8/20/2018 5:28:09 PM	8/20/2018 5:28 PM
Details	Last Recertification Date	Update	Recertification	10/25/2017 9:45:48 AM	11/6/2017 10:47:20 AM	11/6/2017 10:47 AM
Details	Last Recertification Date	Update	Recertification		10/25/2017 9:45:48 AM	10/25/2017 9:45 AM
Contacts	Authorizing Official	Update		Deveny, Thomas Clifford Interim President and CEO 2343125051	Deveny, Thomas Clifford Interim President and CEO Summa Health 2343125051	10/16/2017 12:18 PM
Contacts	Signed By	Update		Deveny, Thomas Clifford Interim President and CEO 2343125051	Deveny, Thomas Clifford Interim President and CEO Summa Health 2343125051	10/16/2017 12:18 PM
Contacts	Primary Contact	Update		Feucht II, John System Director, Pharmacy Services 3303754397	Feucht II, John System Director, Pharmacy Services Summa Health 3303754397	9/20/2017 8:04 AM
Contacts	Primary Contact	Insert			Feucht II, John System Director, Pharmacy Services 3303754397	7/25/2017 12:57 PM
Contacts	Authorizing Official	Insert			Deveny, Thomas Clifford Interim President and CEO 2343125051	7/25/2017 12:57 PM
Contacts	Signed By	Insert			Deveny, Thomas Clifford Interim President and CEO 2343125051	7/25/2017 12:57 PM
Addresses	Main Address	Insert			95 Arch St. Suite G55 Akron, OH 44304	7/25/2017 12:57 PM
Addresses	Billing Address	Insert			Summa Health - Summa Center 168 E. Market Street P.O. Box 2090 Akron, OH 44309-2090	7/25/2017 12:57 PM
Addresses	Shipping Address	Insert			Summa Health System Pharmacy 525 E. Market St. Akron, OH 44304-2090	7/25/2017 12:57 PM
Details	State	Update		Approved	Active	7/25/2017 12:57 PM
Dates	Participating Approval Date	Update			7/13/2017 12:00:00 AM	7/13/2017 12:38 PM
Details	State	Update		Pending	Approved	7/13/2017 12:38 PM
Dates	Start Date	Update			10/1/2017 12:00:00 AM	7/13/2017 12:38 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_78082	DSH360020C	7/12/2017 10:44 AM
Details	Entity Subname	Update		Richard M. and Yvonne Hamlin Pavilion - Endoscopy / Endoscopy	Richard M. and Yvonne Hamlin Pavilion / Endoscopy	7/12/2017 10:44 AM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_78082	7/10/2017 3:23 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	7/10/2017 3:23 PM
Medicaid Billing	Medicaid: Number	Insert			0227833	7/10/2017 3:23 PM
Medicaid Billing	Medicaid: State	Insert			OH	7/10/2017 3:23 PM
Medicaid Billing	NPI: Number	Insert			1396765681	7/10/2017 3:23 PM
Details	Last Recertification Date	Insert				7/10/2017 3:23 PM
Details	Grant Number	Insert				7/10/2017 3:23 PM
Details	340B ID	Insert				7/10/2017 3:23 PM
Details	Is Authorizing Official EHB Data	Insert				7/10/2017 3:23 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/10/2017 3:23 PM
Details	Medicare Provider Number	Insert			360020	7/10/2017 3:23 PM
Details	Entity Name	Insert			SUMMA HEALTH SYSTEM	7/10/2017 3:23 PM
Details	Program Code	Insert			DSH	7/10/2017 3:23 PM
Details	Entity Subname	Insert			Richard M. and Yvonne Hamlin Pavilion - Endoscopy / Endoscopy	7/10/2017 3:23 PM
Dates	Participating Approval Date	Insert				7/10/2017 3:23 PM
Details	State	Insert			Pending	7/10/2017 3:23 PM
Dates	Registration Date	Insert			7/10/2017 12:00:00 AM	7/10/2017 3:23 PM
Dates	Signed By Date	Insert			7/10/2017 12:00:00 AM	7/10/2017 3:23 PM
Dates	Start Date	Insert				7/10/2017 3:23 PM
Terminations	Termination Comments	Insert				7/10/2017 3:23 PM
Terminations	Termination Date	Insert				7/10/2017 3:23 PM
Terminations	Termination Effective Date	Insert				7/10/2017 3:23 PM
Terminations	Termination Reason	Insert				7/10/2017 3:23 PM