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CLINICAL SPECIALTIES INC
PED363302-00 UNIVERSITY HOSPITALS RAINBOW BABIES AND CHILDREN'S HOSPITAL
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Covered Entity Details
Entity Name
UNIVERSITY HOSPITALS RAINBOW BABIES AND CHILDREN'S HOSPITAL
Subdivision Name
Type
Children's Hospital
340B ID
PED363302-00
Entity Address
11100 EUCLID AVENUE
CLEVELAND, OH 44106
Medicare Provider Number
363302
Participating Start Date
11/13/2009
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
CLINICAL SPECIALTIES INC
Pharmacy Address
6288 HUDSON CROSSING PKWY
HUDSON, OH 44236
Pharmacy Comments
Contract Details
Approval Date
4/8/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael R. Vehovec, Corporate Controller
(216) 767-8729
Contract Pharmacy Representative
Option Care Enterprises, Inc.
Amy McKeen, Regional Director
(440) 823-3173
Signed By Date
4/8/2019
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