Provider Demographics
NPI:1285359034
Name:FAIRLINK HEALTHCARE SYSTEMS LLC
Entity type:Organization
Organization Name:FAIRLINK HEALTHCARE SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VANJAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-690-2801
Mailing Address - Street 1:1111 ELM ST STE 25
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-1540
Mailing Address - Country:US
Mailing Address - Phone:860-690-2801
Mailing Address - Fax:
Practice Address - Street 1:1111 ELM ST STE 25
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1540
Practice Address - Country:US
Practice Address - Phone:860-690-2801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health