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RRC360065-03 FISHER-TITUS MEDICAL CENTER (Active)
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Main Details
Name
FISHER-TITUS MEDICAL CENTER
Subdivision Name
Fisher Titus Convenient Care - Family Medicine
Type
Rural Referral Center
Rural
Yes
340B ID
RRC360065-03
Medicare Provider Number
360065
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/12/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/22/2022
Last Recertification Date
8/31/2024
Contacts
Authorizing Official
Fisher-Titus Health
Brent W Burkey, MD, President
(440) 660-2550
Primary Contact
Fisher Titus Medical Center
Scott Endsley, VP of Finance
(419) 668-8101 Ext: 2904
Addresses
Street Address
368 Milan Ave
Suite D
Norwalk, OH 44857-3106
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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