Organization
FAIRMONT STATE UNIVERSITY
Active
Other names
Fairmont State University Student Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRTA MARTIN PHD (PRESIDENT)
(304) 367-4151
Entity
Organization
Contact information
Practice address
1201 LOCUST AVE FL 3, FAIRMONT, WV 26554-2451
(304) 367-4155
Mailing address
1201 LOCUST AVE FL 3, FAIRMONT, WV 26554-2451
(304) 367-4155
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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