Provider Demographics
NPI:1003439068
Name:MAYFIELD CLINIC INC
Entity Type:Organization
Organization Name:MAYFIELD CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:RADOMSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-5210
Mailing Address - Street 1:PO BOX 643398
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-3398
Mailing Address - Country:US
Mailing Address - Phone:513-221-1100
Mailing Address - Fax:513-569-5297
Practice Address - Street 1:544 CENTRE VIEW BLVD.
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3400
Practice Address - Country:US
Practice Address - Phone:513-221-1100
Practice Address - Fax:859-341-3913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies