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DSH360137J UNIVERSITY HOSPITALS OF CLEVELAND (Terminated)
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Main Details
Name
UNIVERSITY HOSPITALS OF CLEVELAND
Subdivision Name
MEDINA HEALTH CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360137J
Medicare Provider Number
360137
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/18/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/2/2011
Last Recertification Date
9/1/2016
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
UH
Michael R. Vehovec, Corporate Controller
(216) 767-8729
Primary Contact
JOHN E. TAYLOR, DIRECTOR OF REIMBURSEMENT
(216) 767-8793
Addresses
Street Address
4001 CARRICK DRIVE
MEDINA, OH 44256-5387
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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