Organization
THE CLEVELAND CLINIC FOUNDATION
Active
Other names
FAIRVIEW HEALTH CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TIM LONGVILLE (CHIEF ACCOUNTING OFFICER)
(216) 636-7416
Entity
Organization
Contact information
Practice address
18101 LORAIN AVE, CLEVELAND, OH 44111-5612
(216) 476-7119
(216) 476-9905
Mailing address
9500 EUCLID AVE, JJ10, CLEVELAND, OH 44195
(216) 476-7119
(216) 476-9905
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
02-0140100
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2633565
—
OH
01
—
3632355
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/23/2006
Last updated
01/07/2025
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