Provider Demographics
NPI:1326175183
Name:THE CLEVELAND CLINIC FOUNDATION
Entity type:Organization
Organization Name:THE CLEVELAND CLINIC FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP CHIEF FINANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LARAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-445-1343
Mailing Address - Street 1:6801 BRECKSVILLE RD
Mailing Address - Street 2:STE 20, ATTN:DPC RK2-7
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5062
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 PARK WEST BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4218
Practice Address - Country:US
Practice Address - Phone:330-864-8060
Practice Address - Fax:330-864-8074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH77179615332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1009560001Medicare PIN