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Organization

FAIRMEADOWS PHARMACY

Active
Parent organization
FAIRMEADOWS PHARMACY, INC.
Other names
FAIRMEADOWS PHARMACY/HME
Organization subpart
Yes

Provider details

NPI number
Legal business name
FAIRMEADOWS PHARMACY, INC.
Authorized official
MR. DANIEL WALTER ZURAWSKI R.PH. (PRESIDENT)
(219) 836-8700
Entity
Organization

Contact information

Practice address
800 MACARTHUR BLVD STE 29, MUNSTER, IN 46321-2917
(219) 836-8700
(219) 836-7639
Mailing address
800 MACARTHUR BLVD, STE 29, MUNSTER, IN 46321-2917
(219) 836-8700
(219) 836-7639

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
60002227A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100298770A
IN
01
1515038
NCPDP
IN
Enumeration date
06/02/2009
Last updated
09/02/2016
About Stedi
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  • EDI platform