Healthcare Provider Details

I. General information

NPI: 1144437880
Provider Name (Legal Business Name): FMRS HEALTH SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 04/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S EISENHOWER DR
BECKLEY WV
25801-4929
US

IV. Provider business mailing address

101 S EISENHOWER DR
BECKLEY WV
25801-4929
US

V. Phone/Fax

Practice location:
  • Phone: 304-256-7100
  • Fax: 304-256-7160
Mailing address:
  • Phone: 304-256-7100
  • Fax: 304-256-7160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number8
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number8
License Number StateWV

VIII. Authorized Official

Name: MARY M REDMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 304-256-7100