Fairmount Family Pharmacy
Organization Active NPI Pharmacy · Fairmount, WV
NPI 1366429953 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1366429953
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- MP0552253 (WV)
- Legal business name
- FAIRMOUNT FAMILY PHARMACY
- Practice address
- 1325 Locust Avenue
Fairmount, WV 26554 - Phone
- (304) 367-8600
- Fax
- (304) 367-8601
- NPI assigned
- Dec 27, 2005
- Organization subpart
- No
Authorized official
- Name
- Dr. Kimberly A Cheuvront, PHD
- Title
- Assistant Vice President
- Phone
- (304) 367-7488
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | MP0552253 | WV | Yes |
Addresses
Primary practice location
1325 Locust Avenue
Fairmount, WV 26554
Mailing address
1325 Locust Avenue
Fairmount, WV 26554
Phone (304) 367-8600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8500030000 | Medicaid | WV |
Other names
- Marion Health Enterprises
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.