340B Drug Pricing Program Database
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DSH360077 FAIRVIEW HOSPITAL (Active)
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Main Details
Name
FAIRVIEW HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360077
Medicare Provider Number
360077
Additional Details
Current Program Status
Active
Registration Date
4/11/2017
Participating Start Date
7/1/2017
Participating Approval Date
6/8/2017
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
CC Fairview Hospital
John Clifford Mills, Executive Director-Hospital Operations, West Submarket
(216) 492-4803
Primary Contact
Cleveland Clinic
Megan Deal, Program Manager
(216) 337-2663
Addresses
Street Address
18101 LORAIN AVE
CLEVELAND, OH 44111
Billing Address
Cleveland Clinic
6801 Brecksville Road – Suite 20
Mail Code: RK1-25
Independence, OH 44131
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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