Fairview Pharmacy

LBN: One Source Pharmacy Services Inc.
Fairview Pharmacy is an health care organization with primary practice located at 4480 Broadway , New York NY 10040-2606. The organization recently has 5 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Home Infusion Therapy Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Home Infusion Therapy Pharmacy is the primary health care specialty. One Source Pharmacy Services Inc. can be contacted via phone (212) 567-9186, or through Thaker, Jayant K via phone (212) 567-3384.

Contact Information

Primary practice address
4480 Broadway New York NY 10040-2606
Phone: (212) 567-9186
Fax: (866) 486-4959
Website:
Map and Directions
Authorized official contact:
Name: Thaker, Jayant K R.PH.
Phone: (212) 567-3384

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 024844 New York
Suppliers / Community/Retail Pharmacy 3336C0003X 024844 New York
Suppliers / Compounding Pharmacy 3336C0004X 024844 New York
Suppliers / Home Infusion Therapy Pharmacy 3336H0001X 024844 New York
Suppliers / Specialty Pharmacy 3336S0011X 024844 New York

Profile Details

NPI number 1750482980
LBN Legal business name One Source Pharmacy Services Inc.
DBA Doing business as Fairview Pharmacy
Authorized official Thaker, Jayant K R.PH.
Entity Organization
Organization subpart 1 No
Enumeration date Sep 26th, 2006
Last updated Oct 2nd, 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 1750482980 NPPES
New York MEDICAID 02105493

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