Organization
FAIRBANKS HOSPITAL, INC.
Active
Other names
Fairbanks
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY A MILLARD (EVP FINANCE)
(317) 355-5860
Entity
Organization
Contact information
Practice address
8102 CLEARVISTA PKWY, INDIANAPOLIS, IN 46256-1661
(317) 849-8222
(317) 849-1455
Mailing address
8102 CLEARVISTA PKWY, INDIANAPOLIS, IN 46256-1661
(317) 849-8222
(317) 849-1455
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
283Q00000X
Psychiatric Hospital
Primary
835-1-P1P
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100273450A
—
IN
Enumeration date
09/14/2006
Last updated
08/13/2020
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