Covered Entity Details

RRC360027-05 AKRON GENERAL MEDICAL CENTER (Active) - information as of 4/25/2025 12:01:46 AM

Main Details

Name

AKRON GENERAL MEDICAL CENTER

Subdivision Name

Akron General Health and Wellness Center, Stow - Pulmonolgy - PULMONARY FUNCTION HWS

Type

Rural Referral Center

Rural

Yes

340B ID

RRC360027-05

Medicare Provider Number

360027

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/12/2024

Participating Start Date

7/1/2024

Participating Approval Date

6/5/2024

Last Recertification Date

8/16/2024

Contacts

Authorizing Official

Cleveland Clinic Akron General
Theresa Lash-Ritter, President
(330) 344-7679

Primary Contact

Cleveland Clinic
Michael Marchionda, Program Administrator, 340B
(216) 316-8583

Addresses

Street Address

4300 ALLEN ROAD
STOW, OH 44224

Billing Address

Cleveland Clinic
6801 Brecksville Road
Mail Code: RK1-25
Suite 20
Independence, OH 44131

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
Participated starting 7/1/2020; Terminated 7/1/2021; Reinstated 7/1/2024.	06/05/2024

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	0210793	1700828712,1821035940,1912193566

Shipping Addresses

Same as Street Address

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
RRC360027-01	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Medical Center - Vascular Surgery - VEIN CENTER	224 W EXCHANGE ST	AKRON	OH	Terminated
RRC360027-02	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Stow - Cardiovascular - AK GEN-CV MED HWS	4300 ALLEN RD	STOW	OH	Active
RRC360027-03	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Medical Center - Spine - SPINE SPEC PROCED - AKRON	2603 W MARKET ST	AKRON	OH	Active
RRC360027-04	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - Cardiovascular - AK GEN-CV MED HWB	4125 MEDINA RD	AKRON	OH	Active
RRC360027-05	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Stow - Pulmonolgy - PULMONARY FUNCTION HWS	4300 ALLEN ROAD	STOW	OH	Active
RRC360027-06	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General, Kent - Spine 2 - SPINE SPEC PROCED - KENT 1 RM1	265 W MAIN ST	KENT	OH	Active
RRC360027-07	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Green - Cardiovascular - AK GEN-CV MED HWG	1940 TOWN PARK BLVD	UNIONTOWN	OH	Active
RRC360027-08	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General, Kent - Spine - SPINE SPEC PROCED - KENT 2	307 W MAIN ST	KENT	OH	Active
RRC360027-09	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - Oncology - INFUSION HW BATH	4125 Medina Rd	AKRON	OH	Active
RRC360027-10	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Stow - Oncology - INFUSION HW STOW	4300 ALLEN RD	STOW	OH	Active
RRC360027-11	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Stow - Emergency Department - HW STOW ED	4300 ALLEN RD	STOW	OH	Active
RRC360027-12	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Green - Oncology - INFUSION HW GREEN	1940 Town Park Blvd	UNIONTOWN	OH	Active
RRC360027-13	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Medical Center POB - Oncology - POB	224 W EXCHANGE ST	AKRON	OH	Terminated
RRC360027-14	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Green - Emergency Department - HW GREEN ED	1940 TOWN PARK BLVD	UNIONTOWN	OH	Active
RRC360027-15	Child	RRC	AKRON GENERAL MEDICAL CENTER	Edwin Shaw - Alcohol and Drug Recovery Center - ALCOHOL AND DRUG RECOVERY CTR	405 Tallmadge Rd	CUYAHOGA FALLS	OH	Terminated
RRC360027-16	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - Pulmonolgy - PULMONARY FUNCTION HWB	4125 MEDINA RD	AKRON	OH	Active
RRC360027-17	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Medical Center - Orthopaedic Clinic - AK GEN ORTHOPAEDIC CLINIC	224 W EXCHANGE ST	AKRON	OH	Terminated
RRC360027-18	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Medical Center - Urology (CUH) - GUI SPEC PROCED - EXCHANGE ST	320 W EXCHANGE ST	AKRON	OH	Active
RRC360027-19	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General, Fairlawn - Urology (CUH) - GUI SPEC PROCED - FAIRLAWN	2651 W MARKET ST	FAIRLAWN	OH	Active
RRC360027-20	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - Emergency Department - HW BATH ED	4125 Medina Road	AKRON	OH	Active
RRC360027-21	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - HEMATOLOGY/ONCOLOGY - HEMATOLOGY - BATH	4125 MEDINA RD	AKRON	OH	Active
RRC360027-22	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - NEUROLOGY - NEUROLOGY BATH	4125 MEDINA RD	AKRON	OH	Active
RRC360027-23	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - OB/GYN - IVF CLINIC - HW BATH	4125 MEDINA RD	AKRON	OH	Active
RRC360027-24	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - RHEUMATOLOGY - RHEUMATOLOGY - BATH	4125 Medina Rd	AKRON	OH	Active
RRC360027-25	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - SPINE - SPINE SPEC PROCED - BATH	4125 MEDINA RD	AKRON	OH	Active
RRC360027-26	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Green - ENDOCRINOLOGY - ENDOCRINE GREEN	1940 TOWN PARK BLVD	UNIONTOWN	OH	Active
RRC360027-27	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Green - HEMATOLOGY/ONCOLOGY - HEMATOLOGY - GREEN	1940 TOWN PARK BLVD	UNIONTOWN	OH	Active
RRC360027-28	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Green - NEUROLOGY - NEUROLOGY GREEN	1940 TOWN PARK BLVD	UNIONTOWN	OH	Terminated
RRC360027-29	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Green - SPINE - SPINE SPEC PROCED - GREEN	1940 TOWN PARK BLVD	UNIONTOWN	OH	Active
RRC360027-30	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Green - UROLOGY - GUI SPEC PROCED - GREEN	1940 TOWN PARK BLVD	UNIONTOWN	OH	Active
RRC360027-31	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Stow - ENDOCRINOLOGY - ENDOCRINE STOW	4300 ALLEN RD	STOW	OH	Active
RRC360027-32	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Stow - FAMILY MEDICINE - STOW PRIMARY CARE	4300 ALLEN RD	STOW	OH	Active
RRC360027-33	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Stow - HEMATOLOGY/ONCOLOGY - HEMATOLOGY - STOW	4300 ALLEN RD	STOW	OH	Active
RRC360027-34	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Stow - RHEUMATOLOGY - RHEUMATOLOGY - STOW	4300 ALLEN RD	STOW	OH	Active
RRC360027-35	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Medical Center POB - ENDOCRINOLOGY - ENDOCRINE POB	224 W. Exchange St	AKRON	OH	Terminated
RRC360027-36	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Medical Center POB - HEMATOLOGY/ONCOLOGY - HEMATOLOGY - POB	224 W EXCHANGE ST	AKRON	OH	Terminated
RRC360027-37	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General, Market Street - PSYCHIATRY - ALCOHOL AND DRUG RECOVERY CTR	3600 W MARKET ST	AKRON	OH	Active
RRC360027-38	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Medical Office Building, Tallmadge - ORTHOPAEDIC SURGERY - TALLMADGE MOC ORTHOPAEDICS	33 NORTH AVE	TALLMADGE	OH	Active
RRC360027-39	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Stow - ORTHOPAEDIC SURGERY - STOW HWC ORTHOPAEDICS	4300 ALLEN RD	STOW	OH	Active
RRC360027-40	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Green - ORTHOPAEDIC SURGERY - GREEN HWC ORTHOPAEDICS	1946 TOWN PARK BLVD	UNIONTOWN	OH	Active
RRC360027-41	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - ADULT PSYCHIATRY - PSYCH SERVICES OP HWB	4125 MEDINA RD	AKRON	OH	Active
RRC360027-42	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - EPILEPSY - EPILEPSY MONITORING EEG HWB	4125 MEDINA RD	AKRON	OH	Active
RRC360027-43	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - ORTHOPAEDIC SURGERY - BATH HWC ORTHOPAEDICS	4125 MEDINA RD	AKRON	OH	Active
RRC360027-44	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Stow - Urology - Urology OPA	4300 ALLEN RD	STOW	OH	Active
RRC360027-45	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Green - Adult Psychiatry - Behavioral Health OPA	1946 Town Park Blvd	UNIONTOWN	OH	Active
RRC360027-46	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Stow - Psychiatry - Behavioral Health OPA	4300 ALLEN RD	STOW	OH	Active
RRC360027-47	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Medical Office Building, Kent - Cardiology - KENT PPG CBRE CLINICAL CARDIOLOGY	1365 KELSO RD	KENT	OH	Active
RRC360027-48	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Bath - Cardiology - BATH HWC CLINICAL CARDIOLOGY	4125 MEDINA RD	AKRON	OH	Active
RRC360027-49	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Medical Office Building, Kent - Rheumatology - KENT PPG CBRE RHEUMOTOLOGY	1365 KELSO RD	KENT	OH	Active
RRC360027-50	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Health and Wellness Center, Green - Cardiology - GREEN HWC CLINICAL CARDIOLOGY	1946 TOWN PARK BLVD	UNIONTOWN	OH	Active
RRC360027-51	Child	RRC	AKRON GENERAL MEDICAL CENTER	Akron General Medical Office Building, Kent - OB/GYN - KENT PPG CBRE OBGYN	1365 KELSO RD	KENT	OH	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	PC Change Request	Williams, Jonathan Senior Director of Pharmacy - 340B Cleveland Clinic 2164448884	Marchionda, Michael Program Administrator, 340B Cleveland Clinic 2163168583	3/3/2025 11:14 AM
Contacts	Authorizing Official	Update	Change Request	Harte, Brian President Akron General Medical Center 3303446548	Lash-Ritter, Theresa President Cleveland Clinic Akron General 3303447679	2/27/2025 11:31 AM
Details	Last Recertification Date	Update	Recertification		8/16/2024 10:36:44 AM	8/16/2024 10:36 AM
Details	State	Update		Approved	Active	7/1/2024 12:01 AM
Addresses	Billing Address	Insert	Reinstatement		Cleveland Clinic 6801 Brecksville Road Mail Code: RK1-25 Suite 20 Independence, OH 44131	6/5/2024 12:03 PM
Medicaid Billing	Medicaid: Number	Delete	Reinstatement	0069483 (OH)		6/5/2024 12:03 PM
Medicaid Billing	NPI: Number	Delete	Reinstatement	1629092168 (OH)		6/5/2024 12:03 PM
Details	Last Recertification Date	Update	Reinstatement	8/18/2020 5:16:45 PM		6/5/2024 12:03 PM
Dates	Last Date That 340B Drugs Purchased	Update	Reinstatement	7/1/2021 12:00:00 AM		6/5/2024 12:03 PM
Dates	Participating Approval Date	Update	Reinstatement	5/22/2020 1:07:10 PM	6/5/2024 12:03:46 PM	6/5/2024 12:03 PM
Details	State	Update	Reinstatement	Terminated	Approved	6/5/2024 12:03 PM
Dates	Registration Date	Update	Reinstatement	4/13/2020 1:31:54 PM	4/12/2024 3:32:29 PM	6/5/2024 12:03 PM
Dates	Signed By Date	Update	Reinstatement	4/15/2020 7:28:08 PM	6/4/2024 5:33:21 PM	6/5/2024 12:03 PM
Dates	Start Date	Update	Reinstatement	7/1/2020 12:00:00 AM	7/1/2024 12:00:00 AM	6/5/2024 12:03 PM
Terminations	Termination Date	Update	Reinstatement	7/1/2021 12:00:00 AM		6/5/2024 12:03 PM
Terminations	Termination Effective Date	Update	Reinstatement	7/1/2021 12:00:00 AM		6/5/2024 12:03 PM
Terminations	Termination Reason	Update	Reinstatement	Change of covered entity type		6/5/2024 12:03 PM
Details	Comments Public	Insert	Reinstatement		Participated starting 7/1/2020; Terminated 7/1/2021; Reinstated 7/1/2024.	6/5/2024 11:58 AM
Contacts	Primary Contact	Update	Profile Change Request	Williams, Jonathan Director of Pharmacy - 340B Cleveland Clinic 2164448884	Williams, Jonathan Senior Director of Pharmacy - 340B Cleveland Clinic 2164448884	8/27/2023 3:57 PM
Details	State	Update		To Be Terminated	Terminated	7/1/2021 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Hospital Type Change Request		7/1/2021 12:00:00 AM	6/2/2021 3:15 PM
Details	State	Update	Hospital Type Change Request	Active	To Be Terminated	6/2/2021 3:15 PM
Terminations	Termination Date	Update	Hospital Type Change Request		7/1/2021 12:00:00 AM	6/2/2021 3:15 PM
Terminations	Termination Effective Date	Update	Hospital Type Change Request		7/1/2021 12:00:00 AM	6/2/2021 3:15 PM
Terminations	Termination Reason	Update	Hospital Type Change Request		Change of covered entity type	6/2/2021 3:15 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1821035940 ( )		8/18/2020 5:16 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1700828712 ( )		8/18/2020 5:16 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1629092168 ( )		8/18/2020 5:16 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1912193566 ( )		8/18/2020 5:16 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1629092168	8/18/2020 5:16 PM
Medicaid Billing	NPI: State	Insert	Recertification		OH	8/18/2020 5:16 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1700828712	8/18/2020 5:16 PM
Medicaid Billing	NPI: State	Insert	Recertification		OH	8/18/2020 5:16 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821035940	8/18/2020 5:16 PM
Medicaid Billing	NPI: State	Insert	Recertification		OH	8/18/2020 5:16 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1912193566	8/18/2020 5:16 PM
Medicaid Billing	NPI: State	Insert	Recertification		OH	8/18/2020 5:16 PM
Details	Last Recertification Date	Update	Recertification		8/18/2020 5:16:45 PM	8/18/2020 5:16 PM
Details	State	Update		Approved	Active	7/1/2020 12:00 AM
Contacts	Signed By	Insert	New Registration		Harte, Brian President Akron General Medical Center 3303446548	5/22/2020 1:07 PM
Details	340B ID	Update	New Registration		RRC360027-05	5/22/2020 1:07 PM
Details	Entity Subname	Update	New Registration	Akron General Health and Wellness Center, Stow - Pulmonolgy	Akron General Health and Wellness Center, Stow - Pulmonolgy - PULMONARY FUNCTION HWS	5/22/2020 1:07 PM
Dates	Participating Approval Date	Update	New Registration		5/22/2020 1:07:10 PM	5/22/2020 1:07 PM
Details	State	Update	New Registration	Pending	Approved	5/22/2020 1:07 PM
Dates	Signed By Date	Update	New Registration		4/15/2020 7:28:08 PM	5/22/2020 1:07 PM
Dates	Start Date	Update	New Registration		7/1/2020 12:00:00 AM	5/22/2020 1:07 PM
Addresses	Main Address	Insert	New Registration		4300 ALLEN ROAD STOW, OH 44224	4/13/2020 1:31 PM
Addresses	Billing Address	Insert	New Registration		Cleveland Clinic 6801 Brecksville Road Mail Code: RK1-25 Suite 20 Independence, OH 44131	4/13/2020 1:31 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/13/2020 1:31 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		0069483	4/13/2020 1:31 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		OH	4/13/2020 1:31 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/13/2020 1:31 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		0210793	4/13/2020 1:31 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		OH	4/13/2020 1:31 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1821035940	4/13/2020 1:31 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1700828712	4/13/2020 1:31 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1629092168	4/13/2020 1:31 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1912193566	4/13/2020 1:31 PM
Contacts	Primary Contact	Insert	New Registration		Williams, Jonathan Director of Pharmacy - 340B Cleveland Clinic 2164448884	4/13/2020 1:31 PM
Contacts	Authorizing Official	Insert	New Registration		Harte, Brian President Akron General Medical Center 3303446548	4/13/2020 1:31 PM
Details	Last Recertification Date	Insert	New Registration			4/13/2020 1:31 PM
Details	Grant Number	Insert	New Registration			4/13/2020 1:31 PM
Details	340B ID	Insert	New Registration			4/13/2020 1:31 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/13/2020 1:31 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/13/2020 1:31 PM
Details	Medicare Provider Number	Insert	New Registration		360027	4/13/2020 1:31 PM
Details	Entity Name	Insert	New Registration		AKRON GENERAL MEDICAL CENTER	4/13/2020 1:31 PM
Details	Program Code	Insert	New Registration		RRC	4/13/2020 1:31 PM
Details	Entity Subname	Insert	New Registration		Akron General Health and Wellness Center, Stow - Pulmonolgy	4/13/2020 1:31 PM
Dates	Participating Approval Date	Insert	New Registration			4/13/2020 1:31 PM
Details	State	Insert	New Registration		Pending	4/13/2020 1:31 PM
Dates	Registration Date	Insert	New Registration		4/13/2020 1:31:54 PM	4/13/2020 1:31 PM
Dates	Signed By Date	Insert	New Registration			4/13/2020 1:31 PM
Dates	Start Date	Insert	New Registration			4/13/2020 1:31 PM
Terminations	Termination Comments	Insert	New Registration			4/13/2020 1:31 PM
Terminations	Termination Date	Insert	New Registration			4/13/2020 1:31 PM
Terminations	Termination Effective Date	Insert	New Registration			4/13/2020 1:31 PM
Terminations	Termination Reason	Insert	New Registration			4/13/2020 1:31 PM