Provider Demographics
NPI:1760799753
Name:THE CLEVELAND CLINIC FOUNDATION
Entity type:Organization
Organization Name:THE CLEVELAND CLINIC FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-973-3321
Mailing Address - Street 1:6000 W CREEK RD
Mailing Address - Street 2:STE 10
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2182
Mailing Address - Country:US
Mailing Address - Phone:800-223-2273
Mailing Address - Fax:
Practice Address - Street 1:7010 ENGLE RD
Practice Address - Street 2:STE 105
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-8401
Practice Address - Country:US
Practice Address - Phone:440-263-3733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-12
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0670140041Medicare NSC