Provider Demographics
NPI:1174579791
Name:FAIRFIELD HEALTHCARE PROFESSIONALS, INC.
Entity type:Organization
Organization Name:FAIRFIELD HEALTHCARE PROFESSIONALS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:B
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-687-8343
Mailing Address - Street 1:1153 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4056
Mailing Address - Country:US
Mailing Address - Phone:740-687-8990
Mailing Address - Fax:740-687-8230
Practice Address - Street 1:1055 W MARKET ST
Practice Address - Street 2:SUITE H
Practice Address - City:BALTIMORE
Practice Address - State:OH
Practice Address - Zip Code:43105-1283
Practice Address - Country:US
Practice Address - Phone:740-862-4183
Practice Address - Fax:740-862-3704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0153462Medicaid
OHCD3781OtherMEDICARE RAILROAD
OHCD3781OtherMEDICARE RAILROAD