Organization
FAIRMOUNT PHARMACY SERVICES LLC
Active
Other names
FAIRMOUNT PHARMACY SERVICES LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GERARD VOLGRAF (MEMBER LLC PHARMACIST)
(215) 620-0019
Entity
Organization
Contact information
Practice address
1900 GREEN ST, SUITE 2F, PHILADELPHIA, PA 19130-3207
(215) 564-9300
(215) 567-1931
Mailing address
1900 GREEN ST, SUITE 2F, PHILADELPHIA, PA 19130-3207
(215) 564-9300
(215) 567-1931
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PP481626
PA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017523250001
—
PA
01
—
2081667
PK
—
Enumeration date
10/12/2006
Last updated
12/13/2016
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