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DSH360025K FIRELANDS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
FIRELANDS REGIONAL MEDICAL CENTER
Subdivision Name
FIRELANDS COUNSELING AND RECOVERY SERVICES
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360025K
Medicare Provider Number
360025
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/1/2016
Last Recertification Date
9/1/2022
Termination Date
Termination Reason
1/1/2023
Site closure
Contacts
Authorizing Official
Firelands Regional Medical Center
Kevin Riley, CFO
(419) 557-7797
Primary Contact
Firelands Regional Medical Center
Scott Turner, 340B Compliance Analyst
(419) 557-5038
Addresses
Street Address
6150 Park Square Drive
Suite B
Lorain, OH 44053-4153
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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