Provider Demographics
NPI:1669660486
Name:FIBROMYALGIA AND FATIGUE CENTERS, INC.
Entity Type:Organization
Organization Name:FIBROMYALGIA AND FATIGUE CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:HRIM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-788-4001
Mailing Address - Street 1:16415 ADDISON RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3218
Mailing Address - Country:US
Mailing Address - Phone:972-788-4001
Mailing Address - Fax:972-788-4002
Practice Address - Street 1:3750 PALLADIAN VILLAGE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-8200
Practice Address - Country:US
Practice Address - Phone:678-494-7800
Practice Address - Fax:678-494-7990
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIBROMYALGIA AND FATIGUE CENTERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site