Organization
FAIRVIEW HOSPITAL DIALYSIS CENTER
Active
Parent organization
FAIRVIEW HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRVIEW HOSPITAL
Authorized official
MRS. DARLENE RODOWICZ (CHIEF FINANCIAL OFFICER)
(413) 447-2000
Entity
Organization
Contact information
Practice address
10 MAPLE AVE, GREAT BARRINGTON, MA 01230-1904
(413) 854-9910
(413) 854-9911
Mailing address
PO BOX 1172, PITTSFIELD, MA 01202-1172
(413) 447-2000
(413) 447-2803
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
2052
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0373
MVP
NY
01
—
10005803
CDPHP
NY
05
—
1001728
—
MA
05
—
1200542
—
MA
01
—
12257
HEALTH NEW ENGLAND
MA
01
—
20850
BMC HEALTH NET PLAN
MA
01
—
220038
UNICARE MA EMPLOYEE GIC
MA
01
—
221302
HUMANA
KY
01
—
2222003801
BLUE CROSS INPATIENT
MA
01
—
2222003810
BLUE CROSS OUTPATIENT
MA
01
—
2222003830
BLUE CROSS SDC
MA
01
—
6300460
AETNA
—
01
—
900038
HARVARD PILGRIM
MA
01
—
900245
TUFTS HEALTH PLAN OUTPT
MA
01
—
905627
TUFTS HEALTH PLAN INPT
MA
01
—
992756
CONNECTICARE
CT
01
—
HO4359
OXFORD HEALTH PLANS
CT
Enumeration date
03/17/2008
Last updated
01/23/2012
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