Fairlawn Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHA00067 Issued in RI

Legal business name

FAIRLAWN PHARMACY INC

Practice address

582 Smithfield Ave
Pawtucket, RI 02860-1633

Phone

(401) 723-8070

NPI assigned

Feb 27, 2007

Last updated

Sep 12, 2007By 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

Bedros Koosherian, RPH

Title

President

Phone

(401) 723-8070

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1366578775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 SMITHFIELD AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028601633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 SMITHFIELD AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028601633",
            "telephone_number": "401-723-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRLAWN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "KOOSHERIAN",
        "authorized_official_first_name": "BEDROS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-723-8070",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "RI",
            "license": "PHA00067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4101286",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FP00779",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4101286",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Selena Evora, MPH, ECID, CPD
• Romel Exama
• Maria Valeria Fabre, MD
• Brian Anthony Faella, D.P.T.
• Elaine Fain, MD
• Fairlawn Primary Care, Inc
• Jenna Fallago, MSW
• Jaleh Fallah, MD
• Irene Fallon
• Marieliz Falu Iglesias

• Community/Retail Pharmacy in Pawtucket, RI
• Providers in Pawtucket, RI by specialty
• Community/Retail Pharmacy in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.