Healthcare Provider Details

I. General information

NPI: 1467762351
Provider Name (Legal Business Name): FCI BECKLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 INDUSTRIAL PARK RD
BEAVER WV
25813-9529
US

IV. Provider business mailing address

1600 INDUSTRIAL PARK RD
BEAVER WV
25813-9529
US

V. Phone/Fax

Practice location:
  • Phone: 304-252-9758
  • Fax:
Mailing address:
  • Phone: 304-252-9758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KEVIN THOMPSON
Title or Position: HEALTH SERVICES ADMINISTRATOR
Credential:
Phone: 304-252-9758