NPIMap

Organization Active NPI

Del Co Inst Dist Fair Acres Farm Pharmacy

  • Pharmacist
  • Glen Riddle Lima, PA
National Provider Identifier
1528042967
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
HP416553L Issued in PA
Legal business name
DEL CO INST DIST FAIR ACRES FARM PHARMACY
Practice address
340 North Middletown Rd.
Glen Riddle Lima, PA 19037
Phone
(610) 891-5860
Fax
(610) 891-6438
NPI assigned
Nov 30, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark Steven Mulholland, R.PH, MBA
Title
Pharmacy Director
Phone
(610) 891-5860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X HP416553L PA Primary

Addresses

Primary practice location

340 North Middletown Rd.
Glen Riddle Lima, PA 19037

Mailing address

340 N. Middletown Rd.
Glen Riddle-Lima, PA 19037
Phone (610) 891-5860

Other names 1

  • Fair Acres Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
County of Delaware4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528042967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 N. MIDDLETOWN RD.",
            "city": "GLEN RIDDLE-LIMA",
            "state": "PA",
            "postal_code": "19037",
            "telephone_number": "610-891-5860",
            "fax_number": "610-891-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NORTH MIDDLETOWN RD.",
            "city": "GLEN RIDDLE LIMA",
            "state": "PA",
            "postal_code": "19037",
            "telephone_number": "610-891-5860",
            "fax_number": "610-891-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEL CO INST DIST FAIR ACRES FARM PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MULHOLLAND",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "610-891-5860",
        "authorized_official_credential": "R.PH, MBA"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "HP416553L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fair Acres Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glen Riddle Lima, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.