Fitzgerald Seaman Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

021127350 Issued in OH

Legal business name

FITZGERALD SEAMAN PHARMACY, INC.

Practice address

17860-A St RT 247
Seaman, OH 45679

Phone

(937) 386-0701

Fax

(937) 386-1402

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Gerald M Fitzgerald

Title

GM

Phone

(513) 734-7335

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• FITZGERALDS SEAMAN PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1205929882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "SEAMAN",
            "state": "OH",
            "postal_code": "456790247",
            "telephone_number": "937-386-0701",
            "fax_number": "513-734-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17860-A ST RT 247",
            "city": "SEAMAN",
            "state": "OH",
            "postal_code": "45679",
            "telephone_number": "937-386-0701",
            "fax_number": "937-386-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITZGERALD SEAMAN PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "GM",
        "authorized_official_telephone_number": "513-734-7335"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021127350",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2134612",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FITZGERALDS SEAMAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FITZGERALDS SEAMAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Seaman, OH
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.