Fairmont Regional Medical Center
* Payment Location:
 
* Account Number(s) (If you're paying for multiple accounts in this one transaction, please enter the account number(s) and payment amount(s) per account separated by commas in the field below. Ex. 123456 - $25.25, 999999 - $58.69):
 
* Guarantor Name/Patient Name:
 
* Last 4 Digits of the Patients SSN:
* Payment Amount:
 
Technical Support
If you need technical support for this online payment processing application, please send an email to info@frmcwv.com.