Fahrney-Keedy Memorial Home, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

21-004 Issued in MD

Legal business name

FAHRNEY-KEEDY MEMORIAL HOME, INC

Doing business as

Coffman Nursing Home by Fahrney-Keedy

Practice address

1304 Pennsylvania Ave
Hagerstown, MD 21742-3108

Phone

(301) 733-2914

Fax

(301) 733-2078

NPI assigned

Oct 8, 2009

Last updated

Mar 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephen Coetzee, LNHA

Title

President/Ceo

Phone

(301) 671-5017

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Coffman Nursing Home by Fahrney-Keedy Doing business as

Locations

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1477888469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 PENNSYLVANIA AVE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217423108",
            "telephone_number": "301-733-2914",
            "fax_number": "301-733-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 PENNSYLVANIA AVE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217423108",
            "telephone_number": "301-733-2914",
            "fax_number": "301-733-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAHRNEY-KEEDY MEMORIAL HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-08",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "COETZEE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "301-671-5017",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "21-004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417162400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coffman Nursing Home by Fahrney-Keedy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Juris G. Eyler, PA-S
• Michelle Denise Eyler, ANP-BC
• Samantha K Ezolt, PA-C
• Leora Ezri
• Marlene Elizabeth Facine
• Fahrney-Keedy Memorial Home, Inc (Coffman Nursing Home by Fahrney-Keedy)
• Lauren Nicole Fahrney, PMHNP-BC
• Jessica D Faidley
• Sarah N Faith, PA-C
• Eyimofe Fakoyede, MD

• Skilled Nursing Facility in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.