Fryeburg Health Care Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1942 Issued in ME

Legal business name

FRYEBURG HEALTH CARE CENTER, INC.

Practice address

70 Fairview Dr
Fryeburg, ME 04037-1524

Phone

(207) 786-0111

Fax

(207) 783-5016

NPI assigned

Aug 3, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David R. Hicks

Title

Owner

Phone

(207) 786-0111

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1154322808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 SUMMER ST",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042105125",
            "telephone_number": "207-786-0111",
            "fax_number": "207-783-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 FAIRVIEW DR",
            "city": "FRYEBURG",
            "state": "ME",
            "postal_code": "040371524",
            "telephone_number": "207-786-0111",
            "fax_number": "207-783-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRYEBURG HEALTH CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-786-0111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ME",
            "license": "1942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107350000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.