Provider Type Icon

FAIRFIELD CARDIAC CATH LAB NPI 1497823975


NPI Profile

NPI: 1497823975
Provider Name: FAIRFIELD CARDIAC CATH LAB
Classification:Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 36D0947058

Address:
3000 MACK ROAD
SUITE 200
FAIRFIELD, OH
ZIP 45014
Get Directions

Phone: (513) 603-8888

FAIRFIELD CARDIAC CATH LAB is a clinic center in Fairfield, OH. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). FAIRFIELD CARDIAC CATH LAB NPI is 1497823975. The provider is registered as an organization entity type.

The provider's business location address is:

3000 MACK ROAD
SUITE 200
FAIRFIELD, OH
ZIP 45014
Phone: (513) 603-8888

The provider's authorized official is Brenda L Vandeventer .
The authorized official title is Executive Director and has the following contact phone number (513) 603-8888.

The CLIA number assigned to this NPI record is 36D0947058 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/1/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12383424MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/11/2021

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.