340B Drug Pricing Program Database
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RRC360070-05 CLEVELAND CLINIC MERCY HOSPITAL (Active)
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Main Details
Name
CLEVELAND CLINIC MERCY HOSPITAL
Subdivision Name
MERCY HEALTH CENTER PLAIN COMMUNITY - Urgent Care Clinic - PROVIDER BASED PLAIN
Type
Rural Referral Center
Rural
Yes
340B ID
RRC360070-05
Medicare Provider Number
360070
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/16/2023
Participating Start Date
10/1/2023
Participating Approval Date
9/14/2023
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Cleveland Clinic Mercy Hospital
David Stewart, Senior Director of Operations II
(330) 489-1131
Primary Contact
Cleveland Clinic
Michael Marchionda, Program Administrator, 340B
(216) 316-8583
Addresses
Street Address
2638 EASTON ST NE
CANTON, OH 44721-2655
Billing Address
Cleveland Clinic
6801 Brecksville Road
Mail Code: RK1-25
Suite 20
Independence, OH 44131
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (10/1/2020) until terminated effective date: (04/1/2021), reinstatement effective date: (101/2023)
09/14/2023
April 2025
April 2025
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