Organization
FAIRMONT REGIONAL CANCER CENTER
Active
Other names
University Health Associates
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA RUMBLE (PROVIDER ENROLLMENT)
(304) 285-7101
Entity
Organization
Contact information
Practice address
1325 LOCUST AVE, FAIRMONT, WV 26554-1435
(304) 366-9999
(304) 366-9996
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 285-7100
(304) 285-7126
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
—
—
207RX0202X
Medical Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011526000
—
WV
Enumeration date
05/15/2013
Last updated
05/15/2013
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