Healthcare Provider Details

I. General information

NPI: 1962566844
Provider Name (Legal Business Name): ST VINCENT CHARITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 08/04/2025
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 E. 22ND STREET
CLEVELAND OH
44115
US

IV. Provider business mailing address

2475 E. 22ND STREET
CLEVELAND OH
44115
US

V. Phone/Fax

Practice location:
  • Phone: 216-592-2853
  • Fax: 216-592-2875
Mailing address:
  • Phone: 216-592-2853
  • Fax: 216-592-2875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN D. SILVER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 216-241-5813