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PED363303-02 CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (Terminated)
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Main Details
Name
CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON
Subdivision Name
AKRON CHILDREN'S BOSTON HEIGHTS HEALTH CENTER
Type
Children's Hospital
Rural
No
340B ID
PED363303-02
Medicare Provider Number
363303
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/25/2010
Participating Start Date
2/26/2010
Participating Approval Date
2/26/2010
Last Recertification Date
8/20/2021
Termination Date
Termination Reason
7/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Children's Hospital Medical Center of Akron
Alicia Lamancusa, Vice President Finance
(330) 543-8171
Primary Contact
Children's Hospital Medical Center of Akron
John E Lepto, Director of Pharmacy
(330) 543-8167
Addresses
Street Address
328 East Hines HIll Road
HUDSON, OH 44236-1118
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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