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DSH360144 SOUTH POINTE HOSPITAL (Active)
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Main Details
Name
SOUTH POINTE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360144
Medicare Provider Number
360144
Additional Details
Current Program Status
Active
Registration Date
7/10/2020
Participating Start Date
8/14/2020
Participating Approval Date
8/5/2020
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
South Pointe Hospital
John Bruyere, Senior Director of Operations
(216) 491-6233
Primary Contact
Cleveland Clinic
Megan Deal, Program Manager
(216) 337-2663
Addresses
Street Address
4110 WARRENSVILLE CENTER ROAD
WARRENSVILLE HEIGHTS, OH 44122
Billing Address
Cleveland Clinic
6801 Brecksville Road – Suite 20
Mail Code: RK1-25
Independence, OH 44131
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 7/1/2017, terminated 7/1/2018. Reinstated 10/1/2020
08/05/2020
April 2025
April 2025
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