Provider Demographics
NPI:1326627407
Name:FREDERIKSTED HEALTH CARE, INC.
Entity Type:Organization
Organization Name:FREDERIKSTED HEALTH CARE, INC.
Other - Org Name:LENA SCHULTERBRANDT HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MASSERAE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:340-772-0260
Mailing Address - Street 1:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:FREDERIKSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00841-1198
Mailing Address - Country:US
Mailing Address - Phone:340-772-0260
Mailing Address - Fax:866-777-7596
Practice Address - Street 1:1 ESTATE CANE STE 207-209
Practice Address - Street 2:
Practice Address - City:FREDERIKSTED
Practice Address - State:VI
Practice Address - Zip Code:00840-4425
Practice Address - Country:US
Practice Address - Phone:340-772-0260
Practice Address - Fax:866-777-7596
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREDERIKSTED HEALTH CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-06
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)