1083644033 NPI number — CLEVELAND CLINIC WESTON HOSPITAL NONPROFIT CORPORATION

Table of content: (NPI 1083644033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083644033 NPI number — CLEVELAND CLINIC WESTON HOSPITAL NONPROFIT CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLEVELAND CLINIC WESTON HOSPITAL NONPROFIT CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CLEVELAND CLINIC HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083644033
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6801 BRECKSVILLE RD
Provider Second Line Business Mailing Address:
MC: RK2-7
Provider Business Mailing Address City Name:
INDEPENDENCE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44131-5032
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-636-4969
Provider Business Mailing Address Fax Number:
216-636-5956

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 WESTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33331-3602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-689-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LONGVILLE
Authorized Official First Name:
TIM
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF ACCOUNTING OFFICER AND CONTRO
Authorized Official Telephone Number:
216-636-7416

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  4299 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 080095 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 587 . This is a "BCBS OF FLORIDA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100289B000000 . This is a "SECTION 1011" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010220200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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