L

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

05735 Issued in NC

Legal business name

L

Doing business as

Fairbrook Clinic Pharmacy

Practice address

1985 Startown Rd
Hickory, NC 28602-8307

Phone

(828) 328-1169

Fax

(828) 327-4756

NPI assigned

Aug 1, 2006

Last updated

Sep 29, 2014By 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

John Kessel, MD

Title

Owner

Phone

(820) 327-4745

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• FAIRBROOK CLINIC PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1962418616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 STARTOWN RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286028307",
            "telephone_number": "828-328-1169",
            "fax_number": "828-327-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 STARTOWN RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286028307",
            "telephone_number": "828-328-1169",
            "fax_number": "828-327-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "KESSEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "820-327-4745",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "05735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7703179",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0185942",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2068601",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRBROOK CLINIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Hickory, NC
• Providers in Hickory, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.