MEDICARE: CLEVELAND CLINIC HEALTH SYSTEMS

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	282N00000X	General Acute Care Hospital	E0002458	OH

General Provider Information

NPI Number	:	1366514093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND CLINIC HEALTH SYSTEMS

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	216-692-7826
Fax Number	:	216-692-7499

Provider Business Practice Location Address
First Line	:	99 NORTHLINE CIR
Second Line	:	SUITE 211
City	:	EUCLID
State	:	OH
Zip	:	44119-1482
Country	:	US
Telephone Number	:	216-692-7826
Fax Number	:	216-692-7499

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. DELROS COSGROVE
Credential	:	M.D.
Telephone Number	:	216-444-2200

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	08/22/2020

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