Professional Pharmacy Fairview
LBN: Fairview Mtm Pharma, Inc
Professional Pharmacy Fairview is an health care organization with primary practice located at 1002 N Fairview St , Santa Ana CA 92703-1811. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Fairview Mtm Pharma, Inc can be contacted via phone (714) 881-0012, or through Le, Denise T. via phone (714) 881-0012.
Contact Information
Primary practice address
1002 N Fairview St
Santa Ana CA 92703-1811
Phone: (714) 881-0012
Fax: (714) 486-2378
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY54449 | California |
| Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
| NPI number | 1417306200 |
|---|---|
| LBN Legal business name | Fairview Mtm Pharma, Inc |
| DBA Doing business as | Professional Pharmacy Fairview |
| Authorized official | Le, Denise T. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 13th, 2016 |
| Last updated | Feb 20th, 2023 - about last year |
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 | 1417306200 | NPPES |
| California | MEDICAID | 1417306200 | |
| California | Other | PHY 54449 |
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