Provider Demographics
NPI:1063444800
Name:SOUTHWEST GENERAL HEALTH CENTER
Entity Type:Organization
Organization Name:SOUTHWEST GENERAL HEALTH CENTER
Other - Org Name:SOUTHWEST GENERAL HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-816-8071
Mailing Address - Street 1:18659 DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-7059
Mailing Address - Country:US
Mailing Address - Phone:440-816-5040
Mailing Address - Fax:440-816-5038
Practice Address - Street 1:18659 DRAKE RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-7059
Practice Address - Country:US
Practice Address - Phone:440-816-5000
Practice Address - Fax:440-816-5038
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST GENERAL HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-06
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000219163OtherANTHEM
OH0820455Medicaid
5000079OtherUNITED HEALTHCARE
87937OtherQUALCHOICE
1508074OtherUNITED MINE WORKERS
0065710OtherAETNA
OH0820455Medicaid
=========OtherCHAMPUS
0065710OtherAETNA
1508074OtherUNITED MINE WORKERS
=========026OtherMEDICAL MUTUAL OF OH
1508074OtherUNITED MINE WORKERS