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Contact Information

FAIRMOUNT FAMILY PHARMACY
1325 LOCUST AVENUE
FAIRMONT, WV26554
 Phone: 304-367-8600
 Fax: 304-367-8601
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for FAIRMOUNT FAMILY PHARMACY

NPI # 1366429953
LBN Legal business name FAIRMOUNT FAMILY PHARMACY
Authorized official KIMBERLY CHEUVRONT - (ASSISTANT VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/27/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
WV License # MP0552253
WV Medicaid 8500030000
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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