Provider Demographics
NPI:1003860487
Name:CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION
Entity type:Organization
Organization Name:CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP CHIEF FINANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LARAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-445-1343
Mailing Address - Street 1:6801 BRECKSVILLE RD
Mailing Address - Street 2:SUITE 20, ATTN: DPC RK2-7
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5062
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18901 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-1078
Practice Address - Country:US
Practice Address - Phone:216-531-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1133273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000157022OtherANTHEM
OH340714616-00OtherBUREAU WORKERS COMPENSATI
OH2593420Medicaid
OH100118OtherKAISER
5000053OtherUNITED HEALTHCARE
OH0059416OtherAETNA
OH000000157022OtherANTHEM
OH340714616-00OtherBUREAU WORKERS COMPENSATI
OH36-T082Medicare Oscar/Certification