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SCH360125-04 Ashtabula County Medical Center (Active)
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Main Details
Name
Ashtabula County Medical Center
Subdivision Name
The Ashtabula Clinic - Vascular Surgery
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH360125-04
Medicare Provider Number
360125
Outpatient Facility Provider Number
360125
Additional Details
Current Program Status
Active
Registration Date
7/14/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/16/2014
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
ASHTABULA COUNTY MEDICAL CENTER
Alanna Dames, Chief Financial Officer
(440) 997-6553
Primary Contact
ASHTABULA COUNTY MEDICAL CENTER
BARRY H SHICK, Director, Pharmacy
(440) 997-6276
Addresses
Street Address
2422 Lake Avenue
Ashtabula, OH 44004
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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