Organization
FAIRFIELD CARDIAC CATH LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA L VANDEVENTER RN MSN (EXECUTIVE DIRECTOR)
(513) 603-8888
Entity
Organization
Contact information
Practice address
3000 MACK ROAD, SUITE 200, FAIRFIELD, OH 45014
(513) 603-8888
Mailing address
3000 MACK ROAD, SUITE 200, FAIRFIELD, OH 45014
(513) 603-8888
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2383424
—
OH
Enumeration date
12/01/2006
Last updated
08/22/2020
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