NPIMap

Organization Active NPI

Del Sur Pharmacy

Doing business as Fairbanks Pharmacy LTC

  • Long Term Care Pharmacy
  • Rancho Santa Fe, CA
National Provider Identifier
1215434873
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
55594 Issued in CA
Legal business name
DEL SUR PHARMACY
Doing business as
Fairbanks Pharmacy LTC
Practice address
16089 San Dieguito Rd # H102
Rancho Santa Fe, CA 92067-9529
Phone
(858) 759-6625
Fax
(858) 759-6729
NPI assigned
Apr 10, 2018
Last updated
Apr 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Authorized official

Name
Bernard GramlichNPI 1124009246
Title
Ceo
Phone
(858) 759-6625

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 55594 CA Primary

Addresses

Primary practice location

16089 San Dieguito Rd # H102
Rancho Santa Fe, CA 92067-9529

Mailing address

PO Box 9227
Rancho Santa Fe, CA 92067-4227
Phone (858) 759-6625

Other identifiers 1

IdentifierTypeStateIssuer
2176915OtherPK

Other names 1

  • Fairbanks Pharmacy LTC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1523318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523318400000",
    "number": "1215434873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9227",
            "city": "RANCHO SANTA FE",
            "state": "CA",
            "postal_code": "920674227",
            "telephone_number": "858-759-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16089 SAN DIEGUITO RD # H102",
            "city": "RANCHO SANTA FE",
            "state": "CA",
            "postal_code": "920679529",
            "telephone_number": "858-759-6625",
            "fax_number": "858-759-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEL SUR PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-10",
        "last_updated": "2018-04-10",
        "status": "A",
        "authorized_official_last_name": "GRAMLICH",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-759-6625"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "55594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176915",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairbanks Pharmacy LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Santa Fe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.