# FAIRMONT STATE UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fairmont State University Student Health Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326625252
- **Authorized official:** DR. MIRTA MARTIN PHD (PRESIDENT)
- **Authorized official phone:** (304) 367-4151

## Contact information

- **Practice address:** 1201 LOCUST AVE FL 3, FAIRMONT, WV 26554-2451
- **Practice address phone:** (304) 367-4155
- **Mailing address:** 1201 LOCUST AVE FL 3, FAIRMONT, WV 26554-2451
- **Mailing address phone:** (304) 367-4155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/26/2021
- **Last updated:** 03/26/2021