340B Drug Pricing Program Database
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RRC360180-402 CLEVELAND CLINIC HOSPITAL (ToBeTerminated)
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Main Details
Name
CLEVELAND CLINIC HOSPITAL
Subdivision Name
Euclid Medical Office Building - CARDIOLOGY - S POINTE-CV MED-OPA
Type
Rural Referral Center
Rural
Yes
340B ID
RRC360180-402
Medicare Provider Number
360180
Outpatient Facility Provider Number
Additional Details
Current Program Status
ToBeTerminated
Registration Date
4/12/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/11/2022
Last Recertification Date
8/16/2024
Termination Date
Termination Reason
7/1/2025
Business decision by the Covered Entity
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
99 Northline Cir
Suite 235
EUCLID, OH 44119
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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