Fairmount Pharmacy Services LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PP481626 Issued in PA

Legal business name

FAIRMOUNT PHARMACY SERVICES LLC

Practice address

1900 Green St
Suite 2F
Philadelphia, PA 19130-3207

Phone

(215) 564-9300

Fax

(215) 567-1931

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Gerard Volgraf

Title

Member LLC Pharmacist

Phone

(215) 620-0019

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• FAIRMOUNT PHARMACY SERVICES LLC Doing business as

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1295824845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 GREEN ST",
            "address_2": "SUITE 2F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303207",
            "telephone_number": "215-564-9300",
            "fax_number": "215-567-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 GREEN ST",
            "address_2": "SUITE 2F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303207",
            "telephone_number": "215-564-9300",
            "fax_number": "215-567-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMOUNT PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "VOLGRAF",
        "authorized_official_first_name": "GERARD",
        "authorized_official_title_or_position": "MEMBER LLC PHARMACIST",
        "authorized_official_telephone_number": "215-620-0019"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "PA",
            "license": "PP481626",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017523250001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2081667",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRMOUNT PHARMACY SERVICES LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grace Fairbrother
• Brandon Fairless, M.D.
• Alexander Fairman
• Ronald M Fairman, MD
• Fairmount Pharmacy Inc
• Fairview Acquisitions LLC
• Fairview Care Center of Bethlehem Pike SNF LLC
• Faith & Hope Boutique, LLC
• Faith and Grace LLC
• Faith Health Service

• Long Term Care Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Long Term Care Pharmacy in Pennsylvania

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