NPIMap

Organization Active NPI

Fairveola Banks

  • Community/Retail Pharmacy
  • Lynwood, CA
National Provider Identifier
1285621813
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY48607 Issued in CA
Legal business name
FAIRVEOLA BANKS
Doing business as
Intra Rx Drugs Lynwood
Practice address
3628 E Imperial Hwy
Ste 102
Lynwood, CA 90262-2643
Phone
(310) 637-2006
Fax
(310) 637-2522
NPI assigned
Sep 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Authorized official

Name
Bianca Banks
Title
Pharmacy Coordinator
Phone
(310) 637-2006

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY48607 CA Primary

Addresses

Primary practice location

3628 E Imperial Hwy
Ste 102
Lynwood, CA 90262-2643

Mailing address

3628 E Imperial Hwy
Ste 102
Lynwood, CA 90262-2643
Phone (310) 637-2006

Other identifiers 1

IdentifierTypeStateIssuer
2127503OtherPK

Other names 1

  • Intra Rx Drugs Lynwood Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fairveola Banks2 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 3

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": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1285621813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY",
            "address_2": "STE 102",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622643",
            "telephone_number": "310-637-2006",
            "fax_number": "310-637-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY",
            "address_2": "STE 102",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622643",
            "telephone_number": "310-637-2006",
            "fax_number": "310-637-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVEOLA BANKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "BIANCA",
        "authorized_official_title_or_position": "PHARMACY COORDINATOR",
        "authorized_official_telephone_number": "310-637-2006"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY48607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2127503",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intra Rx Drugs Lynwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.