340B Drug Pricing Program Database
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RRC360180-297 CLEVELAND CLINIC HOSPITAL (Active)
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Main Details
Name
CLEVELAND CLINIC HOSPITAL
Subdivision Name
Lorain Family Health Center - FAMILY MEDICINE - LORAIN FAMILY MEDICINE - OPA
Type
Rural Referral Center
Rural
Yes
340B ID
RRC360180-297
Medicare Provider Number
360180
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
5/13/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/20/2022
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Cleveland Clinic Health System
Tim Longville, Chief Accounting Officer and Controller
(216) 636-7416
Primary Contact
Cleveland Clinic
Michael Marchionda, Program Administrator, 340B
(216) 316-8583
Addresses
Street Address
5700 Cooper Foster Park Rd
LN20
LORAIN, OH 44053
Billing Address
Cleveland Clinic
6801 Brecksville Road
Mail Code: RK1-25
Suite 20
Independence, OH 44131
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2020 terminated 7/1/2020. Reinstated on 7/1/2022.
05/20/2022
April 2025
April 2025
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