| Organization Name: | FAIRVIEW HOSPITAL DIALYSIS CENTER |
| NPI Number: | 1235300377 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DARLENE RODOWICZ (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 10 Maple Ave Great Barrington |
| State: | MA US |
| Postal Code: | 012301904 |
| Phone Number: | 4138549910 |
| Fax Number: | 4138549911 |
| NPI Enumeration Date: | 03/17/2008 |
| NPI Last Update Date: | 01/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | 2052 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |