MEDICARE: THE CLEVELAND CLINIC FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0002X	Clinic Pharmacy	02-1223400	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851373476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CLEVELAND CLINIC FOUNDATION

Provider Business Mailing Address
First Line	:	9500 EUCLID AVENUE, JJ10
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-2971
Country	:	US
Telephone Number	:	216-445-2124
Fax Number	:	216-445-2172

Provider Business Practice Location Address
First Line	:	10201 CARNEGIE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-2130
Country	:	US
Telephone Number	:	216-445-2124
Fax Number	:	216-445-0025

Authorized Official
Title or Position	:	CHIEF ACCOUNTING OFFICER
Name	:	MR. TIM LONGVILLE
Credential	:
Telephone Number	:	216-636-7416

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	01/07/2025

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Directions to “THE CLEVELAND CLINIC FOUNDATION ” Practice Location

Language	Start Address	Practice Location

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