Provider Demographics
NPI:1457381782
Name:CLEVELAND CLINIC HOME CARE SERVICES
Entity Type:Organization
Organization Name:CLEVELAND CLINIC HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF ACCOUNTING OFFICER &CONTROLLE
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-445-8990
Mailing Address - Street 1:6801 BRECKSVILLE RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5032
Mailing Address - Country:US
Mailing Address - Phone:216-636-8816
Mailing Address - Fax:216-636-8887
Practice Address - Street 1:6801 BRECKSVILLE RD
Practice Address - Street 2:SUITE 10
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-5032
Practice Address - Country:US
Practice Address - Phone:216-636-8816
Practice Address - Fax:216-636-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020662200332BP3500X, 333600000X, 3336H0001X
OHHMEL11047332BX2000X
FLPH11846333600000X
WVMO0559169333600000X
KYOH837333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000028369OtherANTHEM
6000084OtherUNITED HEALTHCARE
WV6040066000Medicaid
WV000325014OtherBLUE CROSS MOUNTAIN STATE
0997529OtherAETNA
220257OtherBLUE CROSS HIGHMARK
OH341770934002OtherMEDICAL MUTUAL
OH0828804Medicaid
1422382OtherUNITED MINE WORKERS
OH3417093400OtherWORKERS COMPENSATION
NY000589230008OtherBLUE CROSS WESTERN N Y
4960054OtherUNITED RESOURCE NETWORK
OH5281520OtherAETNA OHIO
OH3417093400OtherWORKERS COMPENSATION
6000084OtherUNITED HEALTHCARE
220257OtherBLUE CROSS HIGHMARK
OH341770934002OtherMEDICAL MUTUAL
OH=========026OtherCARE SOURCE
0997529OtherAETNA