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DSH360059HA METROHEALTH MEDICAL CENTER (Terminated)
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Main Details
Name
METROHEALTH MEDICAL CENTER
Subdivision Name
METROHEALTH BROADWAY HEALTH CENTER / RHEUMATOLOGY - BROADWAY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360059HA
Medicare Provider Number
360059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/8/2015
Participating Start Date
10/1/2015
Participating Approval Date
8/4/2015
Last Recertification Date
9/2/2022
Termination Date
Termination Reason
10/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
The MetroHealth System
Nicholas R Sukalac, SVP System Services
(216) 778-7757
Primary Contact
MetroHealth System
Brandon Mark Doppelheuer, Finance and Business Manager
(216) 778-8880
Addresses
Street Address
6835 BROADWAY AVE
MH BROADWAY HLTH CNTR
CLEVELAND, OH 44105-1313
Billing Address
MetroHealth Medical Center
2500 MetroHealth Drive
Cleveland, OH 44109-1900
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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