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General NPI Number Information
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NPI Number | 1043291784
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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 | 11/09/2005
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 9211 EUCLID AVE JJ10 PHARMACY
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City | CLEVELAND
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State | OH
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Zip | 44106-2043
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Country | US
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Telephone | 216-444-2100
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Fax | 216-445-0025
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Provider Business Mailing Address
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Address Line | 9211 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-2043
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Country | US
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Telephone | 216-444-2100
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Fax | 216-445-0025
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Authorized Official
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Title or Position | CHIEF ACCOUNTING OFFICER AND CONTRO
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Name | MR. 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 | 02-0079600
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License Number State | OH
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