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SCH360125-29 Ashtabula County Medical Center (Active)
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Main Details
Name
Ashtabula County Medical Center
Subdivision Name
ASHTABULA COUNTY MEDICAL CENTER - Orwell Family Health Center
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH360125-29
Medicare Provider Number
360125
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/9/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/15/2023
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
ASHTABULA COUNTY MEDICAL CENTER
Alanna Dames, Chief Financial Officer
(440) 997-6553
Primary Contact
ASHTABULA COUNTY MEDICAL CENTER
BARRY H SHICK, Director, Pharmacy
(440) 997-6276
Addresses
Street Address
8220 STATE ROUTE 45
ORWELL, OH 44076-9701
Billing Address
Ashtabula County Medical Center
2420 Lake Ave
Ashtabula, OH 44004
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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