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NPI Code Detail

MEDICARE: FAIRBURN HEALTH CARE CENTER, INC

MEDICARE: FAIRBURN HEALTH CARE CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility10601010GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417923426
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAIRBURN HEALTH CARE CENTER, INC
Provider Business Mailing Address
First Line : 178 W CAMPBELLTON ST
Second Line :
City : FAIRBURN
State : GA
Zip : 30213-1219
Country : US
Telephone Number : 770-964-1320
Fax Number : 770-969-6177
Provider Business Practice Location Address
First Line : 178 W CAMPBELLTON ST
Second Line :
City : FAIRBURN
State : GA
Zip : 30213-1219
Country : US
Telephone Number : 770-964-1320
Fax Number : 770-969-6177
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS
Name : MR. LEE E KARSCHNER
Credential :
Telephone Number : 770-939-8720
Provider Enumeration Date : 02/28/2006
Last Update Date : 08/04/2008

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Directions to “FAIRBURN HEALTH CARE CENTER, INC ” Practice Location

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