Provider Demographics
NPI:1831372705
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:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:B
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:740-687-8095
Mailing Address - Street 1:1253 E MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4058
Mailing Address - Country:US
Mailing Address - Phone:740-687-8805
Mailing Address - Fax:740-687-8803
Practice Address - Street 1:1253 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-4058
Practice Address - Country:US
Practice Address - Phone:740-687-8805
Practice Address - Fax:740-687-8803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP08962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0153462Medicaid
OH0153462Medicaid