Fairmount Pharmacy Inc

LBN: Fairmount Pharmacy Inc
Fairmount Pharmacy Inc is an health care organization with primary practice located at 1900 Green St , Philadelphia PA 19130-3207. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Fairmount Pharmacy Inc can be contacted via phone (215) 567-0364, or through Volgraf, Gerard via phone (215) 567-0364.

Contact Information

Primary practice address
1900 Green St Philadelphia PA 19130-3207
Phone: (215) 567-0364
Fax: (215) 567-1931
Website:
Map and Directions
Authorized official contact:
Name: Volgraf, Gerard RPH
Phone: (215) 567-0364

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PP411438L Pennsylvania

Profile Details

NPI number 1073511242
LBN Legal business name Fairmount Pharmacy Inc
DBA Doing business as Fairmount Pharmacy Inc
Authorized official Volgraf, Gerard RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jul 12th, 2005
Last updated Feb 23rd, 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 1073511242 NPPES
Pennsylvania MEDICAID 0011124960001
Pennsylvania Other 2086440

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