<Unavail>

LBN: Fairview Mtm Pharma, Inc
<Unavail> is an health care organization with primary practice located at 1002 N Fairview St , Santa Ana CA 92703-1811. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Fairview Mtm Pharma, Inc can be contacted via phone (714) 881-0012, or through Le, Denise T. via phone (714) 881-0012.

Contact Information

Primary practice address
1002 N Fairview St Santa Ana CA 92703-1811
Phone: (714) 881-0012
Fax: (714) 486-2378
Website:
Map and Directions
Authorized official contact:
Name: Le, Denise T.
Phone: (714) 881-0012

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X PHY54449 California
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1417306200
LBN Legal business name Fairview Mtm Pharma, Inc
DBA Doing business as <Unavail>
Authorized official Le, Denise T.
Entity Organization
Organization subpart 1 No
Enumeration date Jun 13th, 2016
Last updated Feb 20th, 2023 - about 3 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 1417306200 NPPES
California MEDICAID 1417306200
California Other PHY 54449

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