Organization
FAIRMOUNT PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY CRUMP (PRESIDENT)
(831) 758-0976
Entity
Organization
Contact information
Practice address
124 N MAIN ST, FAIRMOUNT, IN 46928-1654
(765) 948-4111
(765) 948-4226
Mailing address
610 E ROMIE LN, SALINAS, CA 93901-4209
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
333600000X
Pharmacy
60005862A
IN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1505760
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/20/2006
Last updated
09/11/2025
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