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General NPI Number Information
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NPI Number | 1851487086
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Entity Type | Organization
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Legal Business Name | FAIRWAY MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 67252 INDUSTRY LN
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City | COVINGTON
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State | LA
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Zip | 70433-8704
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Country | US
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Telephone | 985-809-9888
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Fax | 985-801-3099
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Provider Business Mailing Address
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Address Line | 67252 INDUSTRY LN
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City | COVINGTON
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State | LA
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Zip | 70433-8704
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Country | US
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Telephone | 985-809-9888
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Fax | 985-809-1588
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Authorized Official
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Title or Position | CEO
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Name | MR. JOHN WILLIAM'BILL' HANKINS
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Credential |
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Telephone | 985-801-6246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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