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PED363303-176 CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (Active)
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Main Details
Name
CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON
Subdivision Name
North Canton Neurology - Neurology
Type
Children's Hospital
Rural
No
340B ID
PED363303-176
Medicare Provider Number
363303
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/10/2023
Participating Start Date
7/1/2023
Participating Approval Date
6/6/2023
Last Recertification Date
8/30/2024
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
6076 Whipple Ave. NW
North Canton, OH 44720
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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