340B Drug Pricing Program Database
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DSH360059SW METROHEALTH MEDICAL CENTER (Terminated)
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Main Details
Name
METROHEALTH MEDICAL CENTER
Subdivision Name
MetroHealth Broadview Heights Sports Medicine and Physical Therapy - Broadview Heights Physical Therapy
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360059SW
Medicare Provider Number
360059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/10/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/26/2023
Last Recertification Date
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Metrohealth Medical Center
Ryan Mezinger, SVP Chief Pharmacy Officer
(216) 778-3012
Primary Contact
The MetroHealth System
Angela Campitelli, Director 340B Program
(216) 778-5008
Addresses
Street Address
2500 MetroHealth Drive
Broadview Heights, OH 44109
Billing Address
MetroHealth Medical Center
2500 MetroHealth Drive
Cleveland, OH, OH 44109
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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