Provider Demographics
NPI:1376579532
Name:SOUTHWEST GENERAL HEALTH CENTER
Entity type:Organization
Organization Name:SOUTHWEST GENERAL HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:440-816-6701
Mailing Address - Street 1:18697 BAGLEY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3417
Mailing Address - Country:US
Mailing Address - Phone:440-816-8071
Mailing Address - Fax:440-816-6716
Practice Address - Street 1:7265 OLD OAK BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3417
Practice Address - Country:US
Practice Address - Phone:440-816-8179
Practice Address - Fax:440-816-8197
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST GENERAL HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-22
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
1508074OtherUNITED MINE WORKERS
OH8295509Medicaid
0065710OtherAETNA
5035374OtherUNITED HEALTHCARE
18120OtherQUALCHOICE
000000076347OtherANTHEM
18120OtherQUALCHOICE
5035374OtherUNITED HEALTHCARE
=========001OtherCARESOURCE
=========001OtherCHAMPUS MH
0065710OtherAETNA
000000076347OtherANTHEM
=========022OtherMED MUTUAL OF OH CHEM DEP
18120OtherQUALCHOICE