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MARC GLASSMAN INC
DSH360037 ST. VINCENT CHARITY MEDICAL CENTER
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Covered Entity Details
Entity Name
ST. VINCENT CHARITY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360037
Entity Address
2351 EAST 22ND STREET
CLEVELAND, OH 44115
Medicare Provider Number
360037
Participating Start Date
1/1/2001
Last Recertification Date
9/12/2022
Entity Termination Date
1/1/2023
Pharmacy Details
Pharmacy Name
MARC GLASSMAN INC
Pharmacy Address
DBA: MARC'S
4519 MAYFIELD RD
DBA MARC'S
SOUTH EUCLID, OH 44121
Pharmacy Comments
Contract Details
Approval Date
7/9/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/29/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
JOAN ROSS, COO
(216) 363-7410
Contract Pharmacy Representative
Kevin Yaugher, President, COO
(216) 265-7700
Signed By Date
7/9/2014
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