340B Drug Pricing Program Database
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DSH360048A UNIV OF TOLEDO MEDL CENTER (Terminated)
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Main Details
Name
UNIV OF TOLEDO MEDL CENTER
Subdivision Name
Glendale Medical Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360048A
Medicare Provider Number
360048
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/15/2016
Last Recertification Date
8/27/2020
Termination Date
Termination Reason
7/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
University of Toledo Medical Center
Russell Wayne Smith, Senior Hospital Administrator
(419) 383-3788
Primary Contact
The University of Toledo Medical Center
Holiday Robin Caton, 340B Specialist
(419) 383-3609
Addresses
Street Address
3355 Glendale Avenue
Toledo, OH 43614
Billing Address
Univ of Toledo Medl Center
3000 Arlington Avenue
Toledo, OH 43614-2589
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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