Provider Demographics
NPI:1487193652
Name:FAIRVIEW EYE CENTER, INC.
Entity Type:Organization
Organization Name:FAIRVIEW EYE CENTER, INC.
Other - Org Name:EYE CENTER OF NORTH OLMSTED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REFERRAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANENE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-333-3060
Mailing Address - Street 1:21375 LORAIN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-2122
Mailing Address - Country:US
Mailing Address - Phone:440-333-3060
Mailing Address - Fax:440-333-0273
Practice Address - Street 1:26777 LORAIN RD STE 203
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3226
Practice Address - Country:US
Practice Address - Phone:440-734-4777
Practice Address - Fax:440-734-0555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAIRVIEW EYE CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-21
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty