Fairmount Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP411438L Issued in PA

Legal business name

FAIRMOUNT PHARMACY INC

Doing business as

Fairmount Pharmacy Inc

Practice address

1900 Green St
Philadelphia, PA 19130-3207

Phone

(215) 567-0364

Fax

(215) 567-1931

NPI assigned

Jul 12, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gerard Volgraf, RPHNPI 1023081718

Title

Pharmacist Manager and VP

Phone

(215) 567-0364

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• FAIRMOUNT PHARMACY INC Doing business as

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gerard Joseph Volgraf, RPH

  • Pharmacist
  • Lafayette Hill, PA
  • NPI 1023081718
  NPD Authorized official
• Joseph McGuffin

  • Pharmacist
  • Philadelphia, PA
  • NPI 1316327505
  NPD (past)
• Kevin Powell, RPH

  • Pharmacist
  • Philadelphia, PA
  • NPI 1760450498
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1073511242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 GREEN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303207",
            "telephone_number": "215-567-0364",
            "fax_number": "215-567-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 GREEN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303207",
            "telephone_number": "215-567-0364",
            "fax_number": "215-567-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMOUNT PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "VOLGRAF",
        "authorized_official_first_name": "GERARD",
        "authorized_official_title_or_position": "PHARMACIST MANAGER AND VP",
        "authorized_official_telephone_number": "215-567-0364",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP411438L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011124960001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2086440",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRMOUNT PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Constance S Fair, PA
• Grace Fairbrother
• Brandon Fairless, M.D.
• Alexander Fairman
• Ronald M Fairman, MD
• Fairmount Pharmacy Services LLC
• Fairview Acquisitions LLC
• Fairview Care Center of Bethlehem Pike SNF LLC
• Faith & Hope Boutique, LLC
• Faith and Grace LLC

• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.