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SUMMA HEALTH RETAIL PHARMACY
DSH360020 SUMMA HEALTH SYSTEM
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Covered Entity Details
Entity Name
SUMMA HEALTH SYSTEM
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360020
Entity Address
525 E. MARKET STREET
AKRON, OH 44309
Medicare Provider Number
360020
Participating Start Date
10/1/2017
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
SUMMA HEALTH RETAIL PHARMACY
Pharmacy Address
AKRON CAMPUS
525 E MARKET ST
AKRON, OH 44304-1619
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/2/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Thomas Clifford Deveny, President and CEO
(234) 312-5050
Contract Pharmacy Representative
Summa Health System
Josh Guy Foster, Pharmacist In Charge
(330) 375-4911
Signed By Date
10/16/2017
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