Healthcare Provider Details

I. General information

NPI: 1700334182
Provider Name (Legal Business Name): FAIRFIELD HEALTHCARE PROFESSIONALS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 11/22/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 E MAIN ST
LANCASTER OH
43130-4056
US

IV. Provider business mailing address

PO BOX 2563
LANCASTER OH
43130
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-2273
  • Fax: 740-687-9059
Mailing address:
  • Phone: 740-687-8990
  • Fax: 740-687-8230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIE GROW
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 740-687-8011