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DSH360048AF UNIV OF TOLEDO MEDL CENTER (Active)
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Main Details
Name
UNIV OF TOLEDO MEDL CENTER
Subdivision Name
Radiology-Diagnostic - Radiology-Orthopaedics
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360048AF
Medicare Provider Number
360048
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/22/2021
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
University of Toledo Medical Center
Russell Wayne Smith, Senior Hospital Administrator
(419) 383-3788
Primary Contact
The University of Toledo Medical Center
Holiday Robin Caton, 340B Specialist
(419) 383-3609
Addresses
Street Address
1125 Hospital Dr.
Toledo, OH 43614
Billing Address
UNIV OF TOLEDO MEDL CENTER
2801 W. BANCROFT STREET
Toledo, OH 43606
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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