Provider Demographics
NPI:1255092821
Name:FRARY FUNERAL HOME & CREMATION SERVICES, INC.
Entity type:Organization
Organization Name:FRARY FUNERAL HOME & CREMATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-393-1414
Mailing Address - Street 1:PO BOX 1036
Mailing Address - Street 2:
Mailing Address - City:OGDENSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:13669-6036
Mailing Address - Country:US
Mailing Address - Phone:315-393-1414
Mailing Address - Fax:315-541-4239
Practice Address - Street 1:515 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:OGDENSBURG
Practice Address - State:NY
Practice Address - Zip Code:13669-2603
Practice Address - Country:US
Practice Address - Phone:315-393-1414
Practice Address - Fax:315-541-4239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02660699Medicaid