Organization
THE CLEVELAND CLINIC FOUNDATION
Active
Other names
Specialty/Home Delivery Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM LONGVILLE (CHIEF ACCOUNTING OFFICER AND CONTRO)
(216) 636-7416
Entity
Organization
Contact information
Practice address
3175 SCIENCE PARK DR, STE AC4-B100, BEACHWOOD, OH 44122-7327
(216) 448-4200
(216) 448-5603
Mailing address
9500 EUCLID AVE, AC5B-137, CLEVELAND, OH 44195-0001
(216) 448-4200
(216) 448-5603
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
02-200335003
OH
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3119815
—
OH
Enumeration date
11/09/2009
Last updated
01/09/2025
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