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Fairmont Pharmacy
Long Term Care Pharmacy in Lodi, California
NPI 1104694371

Fairmont Pharmacy is a Long Term Care Pharmacy based in Lodi, CA and is specialized in Long Term Care Pharmacy. Fairmont Pharmacy practices in Lodi, CA. The NPI Number for Fairmont Pharmacy is 1104694371 and holds a License No. (California).

The current practice location address for Fairmont Pharmacy is 1121 W Vine St #13, Lodi, CA and can be reached out via phone at 209-625-8633 and via fax at 209-625-8629.

Location: 1121 W Vine St #13, Lodi, CA, 95240
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104694371
Provider Name
Fairmont Pharmacy
Credential
Provider Entity Type
Organization
Address
1121 W Vine St #13, Lodi, CA, 95240
Phone Number
209-625-8633
Fax Number
209-625-8629
Provider Enumeration Date
12/18/2023
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1689063331 05 CA
PHY52074 01 CA FACILITY STATE LICENSE - CALIFORNIA
institution
Provider Business Practice Location Address Details
Address
1121 W Vine St #13
City
Lodi
State
California
Zip
95240
Phone Number
209-625-8633
Fax Number
209-625-8629
person
Provider Business Mailing Address Details
Address
1121 W Vine St #13
City
Lodi
State
California
Zip
95240
Phone Number
209-625-8633
Fax Number
209-625-8629
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Pharmacy
Speciality
Long Term Care Pharmacy
Taxonomy
3336L0003X
License No.
()
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
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