Fairview Health Of Southport, Llc

NPI 1811087018 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1811087018
Enumeration Date 10/16/2006
Last Updated 10/15/2012
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name TIMOTHY TIMOTHY
Position CONTROLLER
Phone (203) 259-7894
Fax (203) 254-3720
Practice Location
930 MILL HILL TER
SOUTHPORT CT, 06890-1265, US
Phone (203) 259-7894
Fax (203) 254-3720
Business Location
930 MILL HILL TER
SOUTHPORT CT, 06890-1265, US
Phone (203) 259-7894
Fax (203) 254-3720
Toxanomy
Taxonomy Code 314000000X
License State Connecticut
License Number 2307-C
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According to our database, Fairview Health Of Southport, Llc NPI is 1811087018, taxonomy code is 314000000X and license number is 2307-C, license state is located at Connecticut. Fairview Health Of Southport, Llc physically located at 930 Mill Hill Ter, Southport CT, 06890-1265. NPI Number 1033115704 has the healthcare provider type.

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1811087018 NPI number is provided on an as is basis without warranty of any kind. 1811087018 is maintained by the National Plan & Provider Enumeration System. The contents of Fairview Health Of Southport, Llc are for informational purposes only.