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PED363303-11 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 HOSPITAL PEDIATRICS KENT OFFICE
Type
Children's Hospital
Rural
No
340B ID
PED363303-11
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
8/19/2016
Termination Date
Termination Reason
7/1/2017
Site closure
Contacts
Authorizing Official
Akron Childrens Hospital
Spencer Anthony Kowal, Chief Financial Officer and Treasurer
(330) 543-4456
Primary Contact
Children's Hospital Medical Center of Akron
JOHN E. LEPTO, DIRECTOR OF PHARMACY SERVICES
(330) 543-8320
Addresses
Street Address
1951 ROUTE 59
KENT, OH 44240
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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