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DSH360137C UNIVERSITY HOSPITALS OF CLEVELAND (Terminated)
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Main Details
Name
UNIVERSITY HOSPITALS OF CLEVELAND
Subdivision Name
SUBURBAN HEALTH CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360137C
Medicare Provider Number
360137
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/27/2006
Participating Start Date
7/1/2004
Participating Approval Date
10/27/2006
Last Recertification Date
9/1/2016
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
UH
Michael R. Vehovec, Corporate Controller
(216) 767-8729
Primary Contact
Carl H. Lufter Jr., Director of Pharmacy Services
(216) 844-8462
Addresses
Street Address
1611 SOUTH GREEN ROAD
SOUTH EUCLID, OH 44121
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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