Fitzpatrick Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PS006166 Issued in MO

Legal business name

FITZPATRICK PHARMACY INC

Practice address

15394 Manchester Rd
Ballwin, MO 63011-3052

Phone

(636) 394-6622

Fax

(636) 394-9222

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Mark Rathgeber, RPH

Title

Owner

Phone

(636) 394-6622

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• FITZPATRICK PHARMACY INC Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Omobola Taiwo, RPH

  • Pharmacist
  • Ellisville, MO
  • NPI 1821110461
  NPD (past)

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1154425114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15394 MANCHESTER RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113052",
            "telephone_number": "636-394-6622",
            "fax_number": "636-394-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15394 MANCHESTER RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113052",
            "telephone_number": "636-394-6622",
            "fax_number": "636-394-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITZPATRICK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "RATHGEBER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-394-6622",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "PS006166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049588",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600397301",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620397307",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FITZPATRICK PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zain Fatima, DMD
• Mary Jo Faulkner
• Gabrielle Marie Feltner
• Sophia J Finder, RDN
• Nolan Brian Finney
• Jocelyn M Flowers, MA
• Dustin Flynn, ATC, CSCS
• Nancy Patterson Flynn, MS, ATC, CSCS
• Foot & Ankle Center, LLC
• Foot Healers Holdings - St. Louis, LLC

• Community/Retail Pharmacy in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.