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DSH360020BM SUMMA HEALTH SYSTEM (Terminated)
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Main Details
Name
SUMMA HEALTH SYSTEM
Subdivision Name
Canton-Ignatia Hall - Psych
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360020BM
Medicare Provider Number
360020
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2018
Participating Start Date
1/1/2019
Participating Approval Date
10/29/2018
Last Recertification Date
9/14/2022
Termination Date
Termination Reason
10/1/2023
Site closure
Contacts
Authorizing Official
Summa Health
Thomas Clifford Deveny, President and CEO
(234) 312-5050
Primary Contact
Summa Health
John Feucht II, Vice President, Pharmacy Services
(330) 375-4397
Addresses
Street Address
3730 Whipple Ave NW
Suite 5
Canton, OH 44718
Billing Address
Summa Health
1077 Gorge Blvd.
Akron, OH 44310
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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