Covered Entity Details

DSH360075 UH REGIONAL HOSPITALS (Terminated) - information as of 5/16/2025 11:30:44 PM

Main Details

Name

UH REGIONAL HOSPITALS

Subdivision Name

Type

Disproportionate Share Hospital

Rural

340B ID

DSH360075

Medicare Provider Number

360075

Additional Details

Current Program Status

Terminated

Registration Date

7/2/2020

Participating Start Date

10/1/2020

Participating Approval Date

7/16/2020

Last Recertification Date

Termination Date
Termination Reason

10/1/2021
Business decision by the Covered Entity

Contacts

Authorizing Official

UH
Michael R. Vehovec, Corporate Controller
(216) 767-8729

Primary Contact

University Hospitals
Dana Daniels, SFA
(216) 286-0111

Addresses

Street Address

27100 CHARDON ROAD
RICHMOND HEIGHTS, OH 44143

Billing Address
Same as Street Address

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	7344190
		1669562864

Shipping Addresses

Shipping Address 1

UH Richmond Medical Center
27100 Chardon Road
Richmond Heights, OH 44143

Shipping Address 2

UH Bedford Medical Center
44 Blaine Ave
Bedford, OH 44146

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
Contract Detail	UNIVERSITY HOSPITALS	HOME CARE SERVICES INC	4510 RICHMOND ROAD	WARRENSVILLE HEIGHTS	OH	44128	07/16/2020	10/01/2020		10/01/2021	10/01/2021
Contract Detail	UNIVERSITY HOSPITALS HOME CARE SERVICES,	D.B.A UNIVERSITY HOSPITALS HOME DELIVERY	24865B EMERY RD	WARRENSVILLE HEIGHTS	OH	44128	07/16/2020	10/01/2020		10/01/2021	10/01/2021

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH360075A	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Respiratory Therapy	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075B	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - CT	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075C	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - EEG	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075D	Child	DSH	UH REGIONAL HOSPITALS	BEDFORD MEDICAL OFFICE BUILDING - Urology Institute	88 CENTER RD	BEDFORD	OH	Terminated
DSH360075E	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Vascular Lab	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075F	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Mammography	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075G	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Surgery	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075H	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Endoscopy	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075J	Child	DSH	UH REGIONAL HOSPITALS	UH WARRENSVILLE OPT & NEURO REHAB - Physical Therapy	4480 RICHMOND RD	WARRENSVILLE HEIGHTS	OH	Terminated
DSH360075K	Child	DSH	UH REGIONAL HOSPITALS	UH WARRENSVILLE OPT & NEURO REHAB - Occupational Therapy	4480 RICHMOND RD	WARRENSVILLE HEIGHTS	OH	Terminated
DSH360075L	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Wound Care	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075M	Child	DSH	UH REGIONAL HOSPITALS	BEDFORD MEDICAL OFFICE BUILDING - HOPD Urology & Female Med	88 CENTER RD	BEDFORD	OH	Terminated
DSH360075N	Child	DSH	UH REGIONAL HOSPITALS	RICHMOND MEDICAL OFFICE BUILDING - Richmond Wellness	27155 CHARDON RD	RICHMOND HEIGHTS	OH	Terminated
DSH360075P	Child	DSH	UH REGIONAL HOSPITALS	UH WARRENSVILLE OPT & NEURO REHAB - Adult Speech	4480 RICHMOND RD	WARRENSVILLE HEIGHTS	OH	Terminated
DSH360075Q	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Anesthesia	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075R	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Cardiac Cath Lab	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075S	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Diagnostic Radiology	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075T	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Emergency	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075U	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Speech	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075V	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Urology/Gyn	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075W	Child	DSH	UH REGIONAL HOSPITALS	RICHMOND MEDICAL OFFICE BUILDING - HOPD Wound Center	27155 CHARDON RD	RICHMOND HEIGHTS	OH	Terminated
DSH360075X	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - Adult EKG	44 BLAINE AVE	BEDFORD	OH	Terminated
DSH360075Y	Child	DSH	UH REGIONAL HOSPITALS	UH REGIONAL HOSPITALS - MRI	44 BLAINE AVE	BEDFORD	OH	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	10/1/2021 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		7/13/2021 12:00:00 AM	7/15/2021 10:00 AM
Details	State	Update	Termination Request	Active	To Be Terminated	7/15/2021 10:00 AM
Terminations	Termination Date	Update	Termination Request		10/1/2021 12:00:00 AM	7/15/2021 10:00 AM
Terminations	Termination Effective Date	Update	Termination Request		7/13/2021 12:00:00 AM	7/15/2021 10:00 AM
Terminations	Termination Reason	Update	Termination Request		Business decision by the Covered Entity	7/15/2021 10:00 AM
Details	State	Update		Approved	Active	10/1/2020 12:01 AM
Contacts	Signed By	Insert	New Registration		Vehovec, Michael R. Corporate Controller UH 2167678729	7/16/2020 9:07 AM
Details	340B ID	Update	New Registration		DSH360075	7/16/2020 9:07 AM
Dates	Participating Approval Date	Update	New Registration		7/16/2020 9:07:30 AM	7/16/2020 9:07 AM
Details	State	Update	New Registration	Pending	Approved	7/16/2020 9:07 AM
Dates	Signed By Date	Update	New Registration		7/14/2020 2:29:34 PM	7/16/2020 9:07 AM
Dates	Start Date	Update	New Registration		10/1/2020 12:00:00 AM	7/16/2020 9:07 AM
Addresses	Main Address	Insert	New Registration		27100 CHARDON ROAD RICHMOND HEIGHTS, OH 44143	7/2/2020 3:29 PM
Addresses	Shipping Address	Insert	New Registration		UH Richmond Medical Center 27100 Chardon Road Richmond Heights, OH 44143	7/2/2020 3:29 PM
Addresses	Shipping Address	Insert	New Registration		UH Bedford Medical Center 44 Blaine Ave Bedford, OH 44146	7/2/2020 3:29 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/2/2020 3:29 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		7344190	7/2/2020 3:29 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		OH	7/2/2020 3:29 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1669562864	7/2/2020 3:29 PM
Contacts	Authorizing Official	Insert	New Registration		Vehovec, Michael R. Corporate Controller UH 2167678729	7/2/2020 3:29 PM
Contacts	Primary Contact	Insert	New Registration		Daniels, Dana SFA University Hospitals 2162860111	7/2/2020 3:29 PM
Details	Last Recertification Date	Insert	New Registration			7/2/2020 3:29 PM
Details	Grant Number	Insert	New Registration			7/2/2020 3:29 PM
Details	340B ID	Insert	New Registration			7/2/2020 3:29 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/2/2020 3:29 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/2/2020 3:29 PM
Details	Medicare Provider Number	Insert	New Registration		360075	7/2/2020 3:29 PM
Details	Entity Name	Insert	New Registration		UH REGIONAL HOSPITALS	7/2/2020 3:29 PM
Details	Program Code	Insert	New Registration		DSH	7/2/2020 3:29 PM
Details	Entity Subname	Insert	New Registration			7/2/2020 3:29 PM
Dates	Participating Approval Date	Insert	New Registration			7/2/2020 3:29 PM
Details	State	Insert	New Registration		Pending	7/2/2020 3:29 PM
Dates	Registration Date	Insert	New Registration		7/2/2020 3:29:16 PM	7/2/2020 3:29 PM
Dates	Signed By Date	Insert	New Registration			7/2/2020 3:29 PM
Dates	Start Date	Insert	New Registration			7/2/2020 3:29 PM
Terminations	Termination Comments	Insert	New Registration			7/2/2020 3:29 PM
Terminations	Termination Date	Insert	New Registration			7/2/2020 3:29 PM
Terminations	Termination Effective Date	Insert	New Registration			7/2/2020 3:29 PM
Terminations	Termination Reason	Insert	New Registration			7/2/2020 3:29 PM