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General NPI Number Information
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NPI Number | 1013090059
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Entity Type | Organization
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Legal Business Name | THE CLEVELAND CLINIC FOUNDATION
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 18101 LORAIN AVE
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City | CLEVELAND
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State | OH
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Zip | 44111-5612
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Country | US
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Telephone | 216-476-7119
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Fax | 216-476-9905
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Provider Business Mailing Address
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Address Line | 9500 EUCLID AVE, JJ10
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City | CLEVELAND
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State | OH
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Zip | 44195
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Country | US
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Telephone | 216-476-7119
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Fax | 216-476-9905
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Authorized Official
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Title or Position | CHIEF ACCOUNTING OFFICER
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Name | TIM LONGVILLE
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Credential |
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Telephone | 216-636-7416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 02-0140100
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License Number State | OH
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