Organization
CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION
Active
Other names
South Pointe Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY L. LONGVILLE (CHIEF ACCT OFFICER AND CONTROLLER)
(216) 636-7416
Entity
Organization
Contact information
Practice address
20000 HARVARD AVE, WARRENSVILLE HEIGHTS, OH 44122-6805
(216) 491-6000
Mailing address
6801 BRECKSVILLE RD, SUITE 20 RK 10, INDEPENDENCE, OH 44131-5032
(216) 636-8052
(216) 636-8088
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
1297
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000157027
ANTHEM
OH
01
—
0062834
AETNA
OH
01
—
100120
KAISER
OH
01
—
340811464-00
BUREAU WORKERS COMPENSATI
OH
01
—
5000056
UNITED HEALTHCARE
OH
05
—
8552507
—
OH
Enumeration date
05/20/2006
Last updated
04/07/2022
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