Provider Demographics
NPI:1770778102
Name:FCP, INC.
Entity type:Organization
Organization Name:FCP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:FORSTER
Authorized Official - Suffix:IV
Authorized Official - Credentials:PSYD
Authorized Official - Phone:812-446-2833
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:BRAZIL
Mailing Address - State:IN
Mailing Address - Zip Code:47834-0515
Mailing Address - Country:US
Mailing Address - Phone:812-446-2833
Mailing Address - Fax:812-446-2833
Practice Address - Street 1:11295 NCR 300W
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834
Practice Address - Country:US
Practice Address - Phone:812-446-2833
Practice Address - Fax:812-446-2833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1530980OtherUMWA
IN000000499223OtherBLUE CROSS BLUE SHIELD
IN1530980OtherUMWA
INS24150Medicare UPIN