FAIRFAX MANOR LLC
NPI 1497841324
Nursing Facility/Intermediate Care Facility in Sallisaw, OK

Q: What is Fairfax Manor LLC's NPI number?

The NPI number for Fairfax Manor LLC is 1497841324. It was assigned to this organization in the NPPES registry on October 5, 2006.

Q: What is Fairfax Manor LLC's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Q: When was this NPI record last updated?

The NPPES record for Fairfax Manor LLC was last updated on August 24, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 05, 2006

210 EAST CHOCTAW STREET, SALLISAW, OK 74955(918) 775-4439(918) 775-9242 Get Directions Write a Review

NPPES record last updated: August 24, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Fairfax Manor Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRFAX MANOR LLC (NPI 1497841324) is a healthcare organization registered as a nursing facility/intermediate care facility in Sallisaw, Oklahoma and active in the NPI registry since October 2006. The organization lists Justin Mcgrew, Business Management, as its authorized official.

NPPES Registry Identity

NPI1497841324

Entity TypeOrganization

Primary Taxonomy313M00000X

Legal Business NameFAIRFAX MANOR LLC

Location Address210 EAST CHOCTAW STREETSallisaw, OK 74955-0429

Mailing AddressPo Box 429Sallisaw, OK 74955-0429 · (918) 775-4439 · Fax (918) 775-9242

Phone(918) 775-4439

Fax(918) 775-9242

Organization SubpartNo

Authorized OfficialJustin McgrewBusiness Management · (918) 775-4439

Enumeration DateOctober 5, 2006

Last NPPES UpdateAugust 24, 2007

✔ NPI 1497841324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities

Taxonomy Code313M00000X

License✔ Licensed in OK · NH5702-5702

Definition

An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

210 EAST CHOCTAW STREET, Sallisaw, OK 74955

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Other Identifiers 1

Medicare ID-Type Unspecified375467OK · Medicare

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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