Organization
FAIRVIEW HOSPITAL
Active
Other names
Cleveland Clinic Foundation Fairview Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY LONGVILLE (CHIEF ACCOUNTING OFFICER AND CONTRO)
(216) 636-7416
Entity
Organization
Contact information
Practice address
18101 LORAIN AVE, CLEVELAND, OH 44111-5612
(216) 448-0036
(216) 448-0617
Mailing address
PO BOX 92903, CLEVELAND, OH 44194-2903
(440) 808-3700
(440) 808-3675
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208600000X
Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2114723
—
OH
01
—
CA5935
RAILROAD GROUP
OH
01
—
CF8933
RAILROAD GROUP
OH
01
—
CJ0142
RRCARE GRP
OH
Enumeration date
09/20/2006
Last updated
11/06/2019
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