Individual provider Active NPI

Melinda Leigh Fairman, PHARM D

  • Pharmacist
  • San Bernardino, CA
National Provider Identifier
1962832063
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
70243 Issued in CA
Practice address
499 W Orange Show Rd
San Bernardino, CA 92408-2029
Phone
(909) 379-0003
Fax
(909) 521-3759
NPI assigned
Nov 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 70243 CA Primary

Addresses

Primary practice location

499 W Orange Show Rd
San Bernardino, CA 92408-2029

Mailing address

499 W Orange Show Rd
San Bernardino, CA 92408-2029
Phone (909) 379-0003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
70243CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1385424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1962832063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 W ORANGE SHOW RD",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082029",
            "telephone_number": "909-379-0003",
            "fax_number": "909-521-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 W ORANGE SHOW RD",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082029",
            "telephone_number": "909-379-0003",
            "fax_number": "909-521-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRMAN",
        "first_name": "MELINDA",
        "middle_name": "LEIGH",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-26",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "70243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.