Organization
THE CLEVELAND CLINIC FOUNDATION
Active
Other names
Cleveland Clinic North Coast Cancer Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TIM LONGVILLE (CHIEF ACCOUNTING OFFICER)
(216) 636-7416
Entity
Organization
Contact information
Practice address
417 QUARRY LAKES DR, SANDUSKY, OH 44870-8635
(419) 609-2845
(419) 609-2869
Mailing address
9500 EUCLID AVE, JJ10, CLEVELAND, OH 44195-0001
(419) 609-2845
(419) 609-2869
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
022173000
OH
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133727
PK
—
05
—
2734189
—
OH
Enumeration date
05/08/2007
Last updated
01/07/2025
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