Healthcare Provider Details

I. General information

NPI: 1518543941
Provider Name (Legal Business Name): FRASER, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2902 UNIVERSITY DR S
FARGO ND
58103-6032
US

IV. Provider business mailing address

2902 UNIVERSITY DR S
FARGO ND
58103-6032
US

V. Phone/Fax

Practice location:
  • Phone: 701-232-3301
  • Fax: 701-237-5775
Mailing address:
  • Phone: 701-232-3301
  • Fax: 701-237-5775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: AMANDA BARTON
Title or Position: DIRECTOR OF ACCOUNTING
Credential:
Phone: 701-232-3301