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General NPI Number Information
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NPI Number | 1740209816
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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 | 07/19/2006
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 6801 BRECKSVILLE RD MAIL CODE RK1-110
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City | INDEPENDENCE
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State | OH
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Zip | 44131-5058
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Country | US
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Telephone | 330-864-8060
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Fax | 330-864-8074
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Provider Business Mailing Address
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Address Line | 1587 BOETTLER RD SUITE 120
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City | UNIONTOWN
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State | OH
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Zip | 44685-7823
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Country | US
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Telephone | 330-864-8060
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Fax | 330-864-8074
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Authorized Official
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Title or Position | DIRECTOR
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Name | DANIEL MEDVE
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Credential |
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Telephone | 216-973-3321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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