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DSH360059A METROHEALTH MEDICAL CENTER (Terminated)
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Main Details
Name
METROHEALTH MEDICAL CENTER
Subdivision Name
METROHEALTH BUCKEYE HEALTH CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360059A
Medicare Provider Number
360059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/14/2007
Participating Start Date
7/1/1995
Participating Approval Date
6/14/2007
Last Recertification Date
8/6/2015
Termination Date
Termination Reason
1/1/2016
Site closure
Contacts
Authorizing Official
MetroHealth System
Michael Stern, SVP, Chief of Staff
(216) 778-5772
Primary Contact
MetroHealth System
Patricia Radatz, Director, Research and Regulatory Compliance
(216) 778-4968
Addresses
Street Address
2816 EAST 116TH STREET
CLEVELAND, OH 44120
Billing Address
METROHEALTH MEDICAL CENTER
2500 METROHEALTH DRIVE
CLEVELAND, OH 44109
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/24/09 SUBDIV NAME UPDATE, ADDED BILL TO AND SHIP TO ADDR; 3/15/05 CHANGE NAME & ADDRESS FROM CLEMENT CENTER FOR FAMILY CARE PHARMACY 2500 E 79TH ST
03/24/2009
May 2025
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