1467943761 NPI number — THE CLEVELAND CLINIC FOUNDATION

Table of content: (NPI 1467943761)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467943761 NPI number — THE CLEVELAND CLINIC FOUNDATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE CLEVELAND CLINIC FOUNDATION
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:
Provider Other Organization Name Type Code:
6
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:
1467943761
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9500 EUCLID AVE
Provider Second Line Business Mailing Address:
AC5B-137
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44195-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-448-4200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3175 SCIENCE PARK DR
Provider Second Line Business Practice Location Address:
AC4B-103
Provider Business Practice Location Address City Name:
BEACHWOOD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44122-7327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-448-4200
Provider Business Practice Location Address Fax Number:
216-448-5603
Provider Enumeration Date:
05/22/2018

Additional Information

Authorized Official

Authorized Official Last Name:
MEDVE
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
216-973-3321

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336M0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PMY.022003350-0 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2169543 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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