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DSH360059H METROHEALTH MEDICAL CENTER (Terminated)
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Main Details
Name
METROHEALTH MEDICAL CENTER
Subdivision Name
METROHEALTH WEST 150TH HEALTH AND SURGERY CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360059H
Medicare Provider Number
360059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
9/16/2009
Participating Start Date
10/1/2009
Participating Approval Date
9/18/2009
Last Recertification Date
8/10/2015
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
4330 WEST 150TH
CLEVELAND, OH 44130
Billing Address
METROHEALTH MEDICAL CENTER
2500 METROHEALTH DRIVE
CLEVELAND, OH 44109
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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