# FAIRMOUNT PHARMACY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAIRMOUNT PHARMACY SERVICES LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295824845
- **Authorized official:** GERARD VOLGRAF (MEMBER LLC PHARMACIST)
- **Authorized official phone:** (215) 620-0019

## Contact information

- **Practice address:** 1900 GREEN ST, SUITE 2F, PHILADELPHIA, PA 19130-3207
- **Practice address phone:** (215) 564-9300
- **Practice address fax:** (215) 567-1931
- **Mailing address:** 1900 GREEN ST, SUITE 2F, PHILADELPHIA, PA 19130-3207
- **Mailing address phone:** (215) 564-9300
- **Mailing address fax:** (215) 567-1931

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PP481626 | PA | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 12/13/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1017523250001 | — | PA |
| 01 | — | 2081667 | PK | — |