340B Drug Pricing Program Database
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RRC360084-00 AULTMAN HOSPITAL (Active)
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Main Details
Name
AULTMAN HOSPITAL
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC360084-00
Medicare Provider Number
360084
Additional Details
Current Program Status
Active
Registration Date
4/7/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/17/2017
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Aultman
Adam M Luntz, CHIEF FINANCIAL OFFICER
(330) 363-3889 Ext: 0
Primary Contact
Aultman Hospital
Jeffrey M Fostyk, Director of Infusion and 340B Pharmacy Services
(330) 363-6117
Addresses
Street Address
2600 SIXTH STREET SW
CANTON, OH 44710
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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