Provider Demographics
NPI:1205520459
Name:THE CLEVELAND CLINIC FOUNDATION
Entity type:Organization
Organization Name:THE CLEVELAND CLINIC FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE CHIEF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:216-444-6498
Mailing Address - Street 1:9500 EUCLID AVE # JJ-10
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-6498
Mailing Address - Fax:216-445-0025
Practice Address - Street 1:17840 BAGLEY RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3401
Practice Address - Country:US
Practice Address - Phone:440-202-2800
Practice Address - Fax:440-202-2810
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLEVELAND CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy