Provider Demographics
NPI:1831905975
Name:FRINGE HEALTHCARE, LLC
Entity type:Organization
Organization Name:FRINGE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:330-703-0947
Mailing Address - Street 1:1270 S. CLEVELAND-MASSILLON ROAD
Mailing Address - Street 2:BUILDING A, SUITE 110
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321
Mailing Address - Country:US
Mailing Address - Phone:234-466-0009
Mailing Address - Fax:234-466-0372
Practice Address - Street 1:1270 S. CLEVELAND-MASSILLON ROAD
Practice Address - Street 2:BUILDING A, SUITE 110
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321
Practice Address - Country:US
Practice Address - Phone:234-466-0009
Practice Address - Fax:234-466-0372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty