340B Drug Pricing Program Database
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DSH360144H SOUTH POINTE HOSPITAL (Active)
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Main Details
Name
SOUTH POINTE HOSPITAL
Subdivision Name
South Pointe MOB - INTERNAL MEDICINE - RESIDENT CLINIC TECH
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH360144H
Medicare Provider Number
360144
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/3/2023
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
4200 Warrensville Center Rd.
Ste. 353
WARRENSVILLE HEIGHTS, OH 44122
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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