NPIMap

Organization Active NPI

Fairview Hill Realty Corp

Doing business as Fairview Pharmacy and Homecare Supply

  • Institutional Pharmacy
  • Port Jefferson Station, NY
National Provider Identifier
1184797078
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
022326 Issued in NY
Legal business name
FAIRVIEW HILL REALTY CORP
Doing business as
Fairview Pharmacy and Homecare Supply
Practice address
4747 Nesconset Hwy
Ste 10
Port Jefferson Station, NY 11776-2872
Phone
(631) 474-7828
Fax
(631) 474-7871
NPI assigned
Nov 16, 2006
Last updated
Jun 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Authorized official

Name
Michael NastroNPI 1598080764
Title
President
Phone
(631) 474-7828

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X NU
Institutional Pharmacy 3336I0012X 022326 NY Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

4747 Nesconset Hwy
Ste 10
Port Jefferson Station, NY 11776-2872

Mailing address

4747 Nesconset Hwy
Ste 10
Port Jefferson Station, NY 11776-2872
Phone (631) 474-7828

Other identifiers 2

IdentifierTypeStateIssuer
01548030MedicaidNY
2061369OtherPK

Other names 1

  • FAIRVIEW PHARMACY AND HOMECARE SUPPLY Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1184797078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 NESCONSET HWY",
            "address_2": "STE 10",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762872",
            "telephone_number": "631-474-7828",
            "fax_number": "631-474-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 NESCONSET HWY",
            "address_2": "STE 10",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762872",
            "telephone_number": "631-474-7828",
            "fax_number": "631-474-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW HILL REALTY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "NASTRO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-474-7828"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NY",
            "license": "022326",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01548030",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2061369",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRVIEW PHARMACY AND HOMECARE SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.