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PED363303-117 CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (Terminated)
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Main Details
Name
CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON
Subdivision Name
Neurology Boston Heights - Pediatrics
Type
Children's Hospital
Rural
No
340B ID
PED363303-117
Medicare Provider Number
363303
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/16/2022
Participating Start Date
4/1/2022
Participating Approval Date
2/10/2022
Last Recertification Date
8/30/2024
Termination Date
Termination Reason
1/1/2025
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Children's Hospital Medical Center of Akron
Alicia Lamancusa, Vice President Finance
(330) 543-8171
Primary Contact
Akron Children's
Thomas Kyle Finnerty, Director of Pharmacy
(330) 543-8197
Addresses
Street Address
328 East Hines Hill Road
Hudson, OH 44236
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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