Healthcare Provider Details

I. General information

NPI: 1245292358
Provider Name (Legal Business Name): FCMS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 12/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 N LOMBARD STREET #C
OXNARD CA
93030
US

IV. Provider business mailing address

1700 N LOMBARD STREET 3RD FL
OXNARD CA
93030
US

V. Phone/Fax

Practice location:
  • Phone: 805-485-0331
  • Fax: 805-988-1367
Mailing address:
  • Phone: 805-485-3277
  • Fax: 805-988-1367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number8RYAR99701986
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number8RYAR99701986
License Number StateCA

VIII. Authorized Official

Name: MRS. ROBERTA TERI WALSKI
Title or Position: CEO
Credential:
Phone: 805-604-1211