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General NPI Number Information
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NPI Number | 1386088797
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Entity Type | Organization
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Legal Business Name | CLEVELAND CLINIC HEALTH SYSTEM EAST REGION
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 11/11/2015
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Provider Practice Location Address
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Address Line | 18901 LAKE SHORE BLVD
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City | EUCLID
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State | OH
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Zip | 44119
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Country | US
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Telephone | 216-692-8809
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Fax | 216-692-8989
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Provider Business Mailing Address
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Address Line | 18901 LAKE SHORE BLVD
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City | EUCLID
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State | OH
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Zip | 44119
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Country | US
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Telephone | 216-692-8809
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Fax | 216-692-8989
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Authorized Official
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Title or Position | SENIOR DIRECTOR
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Name | MR. DONALD CARROLL
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Credential | MHA, RPH
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Telephone | 216-448-5529
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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 | 02-0032000
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License Number State | OH
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