Fairhaven Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

FAIRHAVEN PHARMACY, INC

Doing business as

Fairhaven Pharmacy

Practice address

72 Main St
Fairhaven, MA 02719-3041

Phone

(508) 525-4455

NPI assigned

Jun 4, 2021

Last updated

Jun 4, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian C Meneses, RPH

Title

Pharmacy Manager

Phone

(508) 525-4455

Specialties & licenses 1

Addresses

Other names 1

• FAIRHAVEN PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Tax ID family

Fairhaven Pharmacy2 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.

• Fairhaven Pharmacy, Inc

  • Long Term Care Pharmacy
  • Fairhaven, MA
  • NPI 1346926482
  NPD tax ID

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1326615758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 MAIN ST",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027193041",
            "telephone_number": "508-525-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 MAIN ST",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027193041",
            "telephone_number": "508-525-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRHAVEN PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "MENESES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "508-525-4455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRHAVEN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eye Health Associates Inc
• Eye Health Associates Inc
• Eye Health Vision Centers, LLC
• Fairhaven Nursing and Rehab LLC
• Fairhaven Opco LLC (Royal of Fairhaven Nursing Center)
• Fairhaven Pharmacy, Inc
• Philip C Falzarano, R PH
• Keri Fazzino, FNP
• Dianne M Feeney, NP
• Jocelyne Marie Fennelly, LICSW, CSAC

• Community/Retail Pharmacy in Fairhaven, MA
• Providers in Fairhaven, MA by specialty
• Community/Retail Pharmacy in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.