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General NPI Number Information
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NPI Number | 1407953706
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Entity Type | Organization
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Legal Business Name | FAIRVIEW HOSPITAL
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 11/06/2019
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Provider Practice Location Address
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Address Line | 18101 LORAIN AVE
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City | CLEVELAND
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State | OH
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Zip | 44111-5612
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Country | US
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Telephone | 216-448-0036
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Fax | 216-448-0617
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Provider Business Mailing Address
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Address Line | PO BOX 92903
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City | CLEVELAND
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State | OH
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Zip | 44194-2903
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Country | US
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Telephone | 440-808-3700
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Fax | 440-808-3675
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Authorized Official
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Title or Position | CHIEF ACCOUNTING OFFICER AND CONTRO
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Name | MR. TIMOTHY LONGVILLE
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Credential |
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Telephone | 216-636-7416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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