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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	905627	OTHER	TUFTS HEALTH PLAN INPT
3	220038	OTHER	UNICARE MA
4	20850	OTHER	BMC HEALTHNET PLAN
5	0373	OTHER	MVP HEALTH CARE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	12257	OTHER	HEALTH NEW ENGLAND
8	2222003810	OTHER	BLUE CROSS OUTPATIENT
9	900245	OTHER	TUFTS HEALTH PLAN OUTPT
10	992756	OTHER	CONNECTICARE
11	2222003801	OTHER	BLUE CROSS INPATIENT
12	2222003830	OTHER	BLUE CROSS SDC
13	6300460	OTHER	AETNA
14	900038	OTHER	HARVARD PILGRIM HEALTH
15	H04359	OTHER	OXFORD
16	10005803	OTHER	CDPHP

General Provider Information

NPI Number	:	1730112251
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	:	413-447-2000
Fax Number	:	413-447-2803

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	:

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

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	01/23/2012

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Directions to “FAIRVIEW HOSPITAL ” Practice Location

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