The Cleveland Clinic Foundation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

022412450 Issued in OH

Legal business name

THE CLEVELAND CLINIC FOUNDATION

Doing business as

CC Mansfield Cancer Center Pharmacy

Practice address

1125 Aspira CT
Mansfield, OH 44906-4125

Phone

(419) 756-2122

NPI assigned

Aug 14, 2014

Last updated

Jan 7, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tim Longville

Title

Chief Accounting Officer

Phone

(216) 636-7416

Specialties & licenses 1

Addresses

Other names 1

• CC Mansfield Cancer Center Pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1730588955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "JJ10",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 ASPIRA CT",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449064125",
            "telephone_number": "419-756-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLEVELAND CLINIC FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-14",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "LONGVILLE",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "216-636-7416"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "022412450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CC Mansfield Cancer Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CC Mansfield Cancer Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Center for Individual and Family Services
• The Center for Individual and Family Services
• The Center for Individual and Family Services (DBA The Rehab Center)
• The Center for Individual and Family Services, Inc. (Catalyst Life Services)
• The Cleveland Clinic Foundation (Cleveland Clinic Park Ave West)
• The Cleveland Clinic Foundation (Cleveland Clinic Mansfield Cancer Center Pharmacy)
• The Hope Home of Richland Couty
• The Kroger Co (Kroger Pharmacy)
• The Kroger Co (Kroger Pharmacy)
• The Kroger Co (Kroger Pharmacy)

• Community/Retail Pharmacy in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.