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PED363303-15 CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (Active)
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Main Details
Name
CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON
Subdivision Name
AKRON CHILDREN'S HOSPITAL PEDIATRICS TALLMADGE OFFICE
Type
Children's Hospital
Rural
No
340B ID
PED363303-15
Medicare Provider Number
363303
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
2/28/2022
Participating Start Date
4/1/2022
Participating Approval Date
3/15/2022
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Children's Hospital Medical Center of Akron
Alicia Lamancusa, Vice President Finance
(330) 543-8171
Primary Contact
Akron Children's
Thomas Kyle Finnerty, Director of Pharmacy
(330) 543-8197
Addresses
Street Address
143 NORTHWEST AVENUE
BUILDING D, STE. 102
TALLMADGE, OH 44278
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 2/26/2010, terminated 7/1/2017. Reinstated 4/1/2022.
03/14/2022
May 2025
May 2025
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