MEDICARE: CLEVELAND CLINIC FOUNDATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	281P00000X	Chronic Disease Hospital
2	282E00000X	Long Term Care Hospital
3	282NC0060X	Critical Access Hospital
4	282NC2000X	Children's Hospital
5	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1073952420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND CLINIC FOUNDATION

Provider Business Mailing Address
First Line	:	2139 CHESTER AVE APT 1103
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115
Country	:	US
Telephone Number	:	602-427-7467
Fax Number	:

Provider Business Practice Location Address
First Line	:	2139 CHESTER AVE APT 1103
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115
Country	:	US
Telephone Number	:	602-427-7467
Fax Number	:

Authorized Official
Title or Position	:	RESIDENCY COORDINATOR
Name	:	MRS. KAREN WALSH
Credential	:
Telephone Number	:	216-444-5539

Provider Enumeration Date	:	06/19/2013
Last Update Date	:	06/19/2013

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Directions to “CLEVELAND CLINIC FOUNDATION ” Practice Location

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