Fairlane Medical Pharmacy
LBN: Fairlane Medical Pharmacy Inc
Fairlane Medical Pharmacy is an health care organization with primary practice located at 6050 Greenfield Rd , Dearborn MI 48126-6004. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Fairlane Medical Pharmacy Inc can be contacted via phone (313) 526-8000, or through Ibrahim, Mohammed via phone (313) 526-8000.
Contact Information
Primary practice address
6050 Greenfield Rd
Dearborn MI 48126-6004
Phone: (313) 526-8000
Fax: (313) 526-8001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 5301009570 | Michigan |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1023309788 |
|---|---|
| LBN Legal business name | Fairlane Medical Pharmacy Inc |
| DBA Doing business as | Fairlane Medical Pharmacy |
| Authorized official | Ibrahim, Mohammed RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 28th, 2011 |
| Last updated | Jun 22nd, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023309788 | NPPES |
| Other | 2375447 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 1023309788 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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