Organization
THE CLEVELAND CLINIC FOUNDATION
Active
Other names
CCF COLE EYE LAKEWOOD
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY L. LONGVILLE (CHIEF ACCT OFFICER AND CONTROLLER)
(216) 636-7416
Entity
Organization
Contact information
Practice address
16215 MADISON AVE, LAKEWOOD, OH 44107-5618
(216) 237-5888
(216) 521-3338
Mailing address
6801 BRECKSVILLE ROAD, SUITE 20 RK2-7, INDEPENDENCE, OH 44131-5058
(216) 636-8926
(216) 442-1272
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
03/07/2019
Last updated
03/31/2022
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