Provider Demographics
NPI:1336991363
Name:UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER
Entity type:Organization
Organization Name:UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:440-935-2753
Mailing Address - Street 1:917 N LAKE ST STE 150
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-1350
Mailing Address - Country:US
Mailing Address - Phone:440-798-6050
Mailing Address - Fax:216-201-8203
Practice Address - Street 1:917 N LAKE ST STE 150
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1350
Practice Address - Country:US
Practice Address - Phone:440-798-6050
Practice Address - Fax:216-201-8203
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-03
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy