Healthcare Provider Details

I. General information

NPI: 1629996582
Provider Name (Legal Business Name): FRED'S GROUP SERVICE LLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 WESSEL DR STE 8B
FAIRFIELD OH
45014-3662
US

IV. Provider business mailing address

759 WESSEL DR STE 8B
FAIRFIELD OH
45014-3662
US

V. Phone/Fax

Practice location:
  • Phone: 513-276-2588
  • Fax:
Mailing address:
  • Phone: 513-276-2588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FRED ACHU
Title or Position: OWNER
Credential: C.E.O
Phone: 513-276-2588