Organization
FAIRCHILD MANOR NURSING HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC I KORN (PRESIDENT OWNER)
(716) 867-4853
Entity
Organization
Contact information
Practice address
765 FAIRCHILD PL, LEWISTON, NY 14092-1309
(716) 634-7600
(716) 633-3369
Mailing address
POST OFFICE BOX 0730, EAST AMHERST, NY 14051-0730
(716) 867-4853
(716) 633-3369
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3121302N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02099296
—
NY
Enumeration date
09/23/2005
Last updated
11/30/2017
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