Provider Demographics
NPI:1508368283
Name:SOUTHWEST GENERAL HEALTH CENTER
Entity Type:Organization
Organization Name:SOUTHWEST GENERAL HEALTH CENTER
Other - Org Name:SOUTHWEST GENERAL PHYSICAL THERAPY
Other - Org Type:Other Name
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 1:18697 BAGLEY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3417
Mailing Address - Country:US
Mailing Address - Phone:440-816-8000
Mailing Address - Fax:
Practice Address - Street 1:5340 ROYALTON RD
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-4008
Practice Address - Country:US
Practice Address - Phone:440-230-1133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST GENERAL HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-08
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000076347OtherANTHEM