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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1598961039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRVIEW HOSPITAL

Provider Business Mailing Address
First Line	:	1730 W 25TH ST
Second Line	:	#122
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3108
Country	:	US
Telephone Number	:	216-363-2475
Fax Number	:	216-696-7269

Provider Business Practice Location Address
First Line	:	4330 W 150TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44135-1362
Country	:	US
Telephone Number	:	440-333-3332
Fax Number	:	440-333-7044

Authorized Official
Title or Position	:	CFO
Name	:	CHRIS WINTERS
Credential	:
Telephone Number	:	216-363-2475

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	08/22/2020

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Directions to “FAIRVIEW HOSPITAL ” Practice Location

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