Organization
FAIRBANKS PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID E VANVALKENBURG R.PH. (OWNER / CHIEF PHARMACIST)
(607) 563-1660
Entity
Organization
Contact information
Practice address
37 MAIN ST, SIDNEY, NY 13838-1139
(607) 563-1660
(607) 563-1762
Mailing address
37 MAIN ST, SIDNEY, NY 13838-1139
(607) 563-1660
(607) 563-1762
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
012692
NY
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01289596
—
NY
01
—
10034668
CDPHP INSURANCE
—
01
—
3317054
NABP
—
01
—
347918
MVP HEALTH PLAN
—
Enumeration date
02/11/2006
Last updated
09/11/2025
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