MEDICARE: SOUTHWEST GENERAL HEALTH CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	0782AS	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5000079	OTHER	OH	UNITED HEALTHCARE
3	000000076347	OTHER	OH	ANTHEM
4	0065710	OTHER	OH	AETNA

General Provider Information

NPI Number	:	1649718321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST GENERAL HEALTH CENTER

Provider Business Mailing Address
First Line	:	18697 BAGLEY RD
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3417
Country	:	US
Telephone Number	:	440-816-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	15345 BAGLEY RD
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-4825
Country	:	US
Telephone Number	:	440-743-8400
Fax Number	:	440-743-8401

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	WILLIAM YOUNG JR.
Credential	:
Telephone Number	:	440-816-6701

Provider Enumeration Date	:	02/02/2017
Last Update Date	:	03/14/2025

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Directions to “SOUTHWEST GENERAL HEALTH CENTER ” Practice Location

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