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FAIRLANE MEDICAL PHARMACY INC NPI 1023309788


NPI Information

NPI: 1023309788
Provider Name: FAIRLANE MEDICAL PHARMACY INC

Doing Business As: FAIRLANE MEDICAL PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
6050 GREENFIELD RD
DEARBORN, MI
ZIP 48126
Phone: (313) 526-8000
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FAIRLANE MEDICAL PHARMACY INC is a community/retail pharmacy pharmacy in Dearborn, MI. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. FAIRLANE MEDICAL PHARMACY INC NPI is 1023309788. The provider is registered as an organization entity type.
The provider Is Doing Business As Fairlane Medical Pharmacy.

The provider's business location address is:

6050 GREENFIELD RD
DEARBORN, MI
ZIP 48126-004
Phone: (313) 526-8000
Fax: (313) 526-8001

The provider's authorized official is Mohammed Ibrahim .
The authorized official title is Member and has the following contact phone number (313) 526-8000.

The enumeration date for this NPI number is 4/28/2011 and was last updated on 6/22/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336L0003XPharmacyLong Term Care PharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy5301009570MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11023309788MEDICAIDMICHIGAN
22375447OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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