Healthcare Provider Details

I. General information

NPI: 1811748635
Provider Name (Legal Business Name): FMC MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2024
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 WARREN SHARON RD
BROOKFIELD OH
44403-9796
US

IV. Provider business mailing address

241 W PARKSIDE DR
NEW CASTLE PA
16105-1081
US

V. Phone/Fax

Practice location:
  • Phone: 330-448-2822
  • Fax:
Mailing address:
  • Phone: 724-714-4936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: FRANCESCA CRUM
Title or Position: CRNP
Credential: CRNP
Phone: 724-714-4936