Healthcare Provider Details

I. General information

NPI: 1699928366
Provider Name (Legal Business Name): FREDERIKSTED HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5A & C VI CORP ESTATE
KINGSHILL VI
00850
US

IV. Provider business mailing address

PO BOX 1198
FREDERIKSTED VI
00841-1198
US

V. Phone/Fax

Practice location:
  • Phone: 340-772-5567
  • Fax: 340-772-4128
Mailing address:
  • Phone: 340-772-0260
  • Fax: 340-772-5895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MASSERAE WEBSTER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 340-772-0260