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Organization
FAWCETT MEMORIAL HOSPITAL, INC.
Active
Organization
FAWCETT MEMORIAL HOSPITAL, INC.
Active
Other names
HCA Florida Fawcett Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
RICK SCHRADER (CFO)
(941) 629-1181
Entity
Organization
Contact information
Practice address
21298 OLEAN BLVD, PORT CHARLOTTE, FL 33952-6705
(941) 629-1181
(941) 627-6142
Mailing address
21298 OLEAN BLVD, PORT CHARLOTTE, FL 33952-6705
(941) 629-1181
(941) 627-6142
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
—
—
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000035953
HUMANA
FL
05
—
000616569X
—
GA
01
—
0007175
AETNA
—
05
—
011746300
—
FL
05
—
01608460
—
NY
01
—
032064700
BLACK LUNG
—
05
—
0968672
—
OH
05
—
11643B
—
SC
01
—
20320
WELLCARE
GA
01
—
20320
WELLCARE/STAYWELL
—
05
—
304862874
—
MI
01
—
571
BLUE CROSS
FL
05
—
HLFL0102
—
MI
Enumeration date
05/22/2006
Last updated
11/07/2025
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