<Unavail>
LBN: Fairmount Pharmacy Inc
<Unavail> 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:
Health care specialties
| Specialty | Code | License # | 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 | <Unavail> |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073511242 | NPPES |
| Pennsylvania | MEDICAID | 0011124960001 | |
| Pennsylvania | Other | 2086440 |
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