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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1285566653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRVIEW HOSPITAL

Provider Business Mailing Address
First Line	:	6801 BRECKSVILLE RD STE 20
Second Line	:	ATTN DPC RK 2-7
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-5062
Country	:	US
Telephone Number	:	999-999-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	10654 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-5411
Country	:	US
Telephone Number	:	216-444-2273
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VP CHIEF FINANCE OFFICER
Name	:	DENNIS LEE LARAWAY
Credential	:
Telephone Number	:	216-445-1343

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “FAIRVIEW HOSPITAL ” Practice Location

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