Fairmont Pharmacy

LBN: Fairmont Pharmacy
Fairmont Pharmacy is an health care organization with primary practice located at 1121 W Vine St Ste 13 Suite 13, Lodi CA 95240-5137. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Fairmont Pharmacy can be contacted via phone (209) 625-8633, or through Tran, Beatle Thienphuoc via phone (209) 938-9556.

Contact Information

Primary practice address
1121 W Vine St Ste 13 Suite 13 Lodi CA 95240-5137
Phone: (209) 625-8633
Fax: (209) 625-8629
Website:
Map and Directions
Authorized official contact:
Name: Tran, Beatle Thienphuoc PHARMD
Phone: (209) 938-9556

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X PHY52074 California

Profile Details

NPI number 1689063331
LBN Legal business name Fairmont Pharmacy
DBA Doing business as
Authorized official Tran, Beatle Thienphuoc PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Jan 20th, 2015
Last updated Mar 17th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689063331 NPPES
California Other PHY52074 CA BOARD OF PHARMACY

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