MEDICARE: FAIRVIEW HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282NC0060X	Critical Access Hospital	2052	MA
2	275N00000X	Medicare Defined Swing Bed Hospital Unit	2052	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0373	OTHER		MVP
2	2222003801	OTHER	MA	BLUE CROSS INPT
3	2222003810	OTHER	MA	BLUE CROSS OUTPT
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	20850	OTHER	MA	BMC HEALTH NET PLAN
6	221302	OTHER		HUMANA
7	900038	OTHER		HARVARD PILGRIM HEALTH
8	220038	OTHER	MA	UNICARE MA EMPLOYEE GIC
9	2222003830	OTHER	MA	BLUE CROSS SDC
10	6300460	OTHER		AETNA
11	10005803	OTHER		CDPHP
12	905627	OTHER		TUFTS HEALTH PLAN INPT
13	992756	OTHER		CONNECTICARE
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	12257	OTHER		HEALTH NEW ENGLAND
16	900245	OTHER		TUFTS HEALTH PLAN OUTPT
17	HO4359	OTHER		OXFORD

General Provider Information

NPI Number	:	1174689467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRVIEW HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 1172
Second Line	:
City	:	PITTSFIELD
State	:	MA
Zip	:	01202-1172
Country	:	US
Telephone Number	:	413-528-0790
Fax Number	:	413-528-8615

Provider Business Practice Location Address
First Line	:	29 LEWIS AVE
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-1713
Country	:	US
Telephone Number	:	413-528-0790
Fax Number	:	413-528-8615

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MRS. DARLENE RODOWICZ
Credential	:
Telephone Number	:	413-447-2000

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	12/13/2012

Similar Medicare Providers

1013998244 — DR. KERSTIN L. VOSS MD
Practice Location Address:

29 LEWIS AVE
GREAT BARRINGTON, MA
01230-1713

Practice Phone: 413-528-0790
Practice Fax:

1437139243 — SOUTHERN BERKSHIRE VOLUNTEER AMBULANCE SQUAD INC
Practice Location Address:

31 LEWIS AVE
GREAT BARRINGTON, MA
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1730112251 — FAIRVIEW HOSPITAL
Practice Location Address:

29 LEWIS AVE
GREAT BARRINGTON, MA
01230-1713

Practice Phone: 413-528-0790
Practice Fax:

1427150374 — KENNETH PATTERSON M.D.
Practice Location Address:

29 LEWIS AVE , FAIRVIEW HOSPITAL EMERGENCY DEPT
GREAT BARRINGTON, MA
01230-1713

Practice Phone: 413-854-9638
Practice Fax: 413-854-9639

1558461087 — BRUCE NAYOWITH M.D.
Practice Location Address:

29 LEWIS AVE , FAIRVIEW HOSPITAL EMERGENCY DEPT
GREAT BARRINGTON, MA
01230-1713

Practice Phone: 413-854-9638
Practice Fax: 413-854-9639

1235279597 — MS. GAYLE ARMSTRONG NP
Practice Location Address:

29 LEWIS AVE
GREAT BARRINGTON, MA
01230-1713

Practice Phone: 413-854-9638
Practice Fax: 413-854-9639

Directions to “FAIRVIEW HOSPITAL ” Practice Location

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