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DSH360137AP UNIVERSITY HOSPITALS OF CLEVELAND (Terminated)
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Main Details
Name
UNIVERSITY HOSPITALS OF CLEVELAND
Subdivision Name
UH Mentor Health Center - Physical Therapy
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360137AP
Medicare Provider Number
360137
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2021
Participating Start Date
10/1/2021
Participating Approval Date
8/18/2021
Last Recertification Date
Termination Date
Termination Reason
7/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
UH
Michael R. Vehovec, Corporate Controller
(216) 767-8729
Primary Contact
University Hospitals
Dana Daniels, SFA
(216) 286-0111
Addresses
Street Address
9000 Mentor Ave
STE 206
Mentor, OH 44060
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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