Provider Demographics
NPI:1881733616
Name:FMRS HEALTH SYSTEMS INC
Entity type:Organization
Organization Name:FMRS HEALTH SYSTEMS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:REDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-256-7100
Mailing Address - Street 1:101 S EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-4929
Mailing Address - Country:US
Mailing Address - Phone:304-256-7100
Mailing Address - Fax:304-256-7160
Practice Address - Street 1:101 S EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-4929
Practice Address - Country:US
Practice Address - Phone:304-256-7100
Practice Address - Fax:304-256-7160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV8261QM0801X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001709451OtherBCBS PAY TO ID
WV0005445002Medicaid
WV001709450OtherBCBS PAY TO ID
WV0005445001Medicaid
WV0005445000Medicaid
WV001802529OtherBCBS PAY TO ID
0134961OtherUMWA
WV3810003487Medicaid
WV0005445002Medicaid
WV3810003487Medicaid
0134961OtherUMWA
WV0005445001Medicaid