NPIMap

Organization Active NPI

Fallon Wellness Pharmacy, LLC

  • Community/Retail Pharmacy
  • Latham, NY
National Provider Identifier
1174911754
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
052563 Issued in NY
Legal business name
FALLON WELLNESS PHARMACY, LLC
Practice address
1057 Troy Schenectady Rd
Latham, NY 12110-1002
Phone
(518) 220-2005
Fax
(518) 220-5004
NPI assigned
Jan 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Authorized official

Name
Erika A Fallon, PHARMDNPI 1699163204
Title
Supervising Pharmacist
Phone
(518) 220-2005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 052563 NY Primary

Addresses

Primary practice location

1057 Troy Schenectady Rd
Latham, NY 12110-1002

Mailing address

1057 Troy Schenectady Rd
Latham, NY 12110-1002
Phone (518) 220-2005

National Provider Directory

National Provider Directory
Tax ID family
Fallon Wellness Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1174911754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 TROY SCHENECTADY RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101002",
            "telephone_number": "518-220-2005",
            "fax_number": "518-220-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 TROY SCHENECTADY RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101002",
            "telephone_number": "518-220-2005",
            "fax_number": "518-220-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLON WELLNESS PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "FALLON",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "518-220-2005",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "052563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.