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DSH360055 TRUMBULL MEMORIAL HOSPITAL (Active)
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Main Details
Name
TRUMBULL MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360055
Medicare Provider Number
360055
Additional Details
Current Program Status
Active
Registration Date
3/28/2025
Participating Start Date
4/1/2025
Participating Approval Date
3/31/2025
Last Recertification Date
Contacts
Authorizing Official
Insight Hospital and Medical Center Chicago
David Charles Hughes, Chief Pharmacy Officer
(401) 249-1963
Primary Contact
Trumball Memorial Hospital
Timothy Gordon, Director of Pharmacy
(330) 841-9458
Addresses
Street Address
1350 EAST MARKET ST.
WARREN, OH 44483
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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