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DSH360059L METROHEALTH MEDICAL CENTER (Terminated)
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Main Details
Name
METROHEALTH MEDICAL CENTER
Subdivision Name
METROHEALTH LEE-HARVARD HEALTH CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360059L
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
4071 LEE ROAD
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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