Fograce Healthcare, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

R2031R Issued in MD

Legal business name

FOGRACE HEALTHCARE, INC

Practice address

3203 Shortridge LN
Mitchellville, MD 20721-2574

Phone

(240) 832-4315

Fax

(301) 249-9568

NPI assigned

Jun 26, 2008

Last updated

Jun 26, 2008By 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

Mrs. Folashade Demuren

Title

Director

Phone

(240) 832-4323

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1629230222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 SHORTRIDGE LN",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207212574",
            "telephone_number": "240-832-4315",
            "fax_number": "301-249-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 SHORTRIDGE LN",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207212574",
            "telephone_number": "240-832-4315",
            "fax_number": "301-249-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOGRACE HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "DEMUREN",
        "authorized_official_first_name": "FOLASHADE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "240-832-4323",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "R2031R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7714131-00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Mitchellville, MD
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• Home Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.