340B Drug Pricing Program Database
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RRC360180-392 CLEVELAND CLINIC HOSPITAL (Active)
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Main Details
Name
CLEVELAND CLINIC HOSPITAL
Subdivision Name
BAINBRIDGE URGENT CARE - URGENT CARE CLINIC - BAINBRIDGE URGENT CARE-OPA
Type
Rural Referral Center
Rural
Yes
340B ID
RRC360180-392
Medicare Provider Number
360180
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/11/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/22/2021
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
17747 CHILLICOTHE RD
STE 100
BAINBRIDGE TOWNSHIP, OH 44023
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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