FAIRMOUNT PHARMACY INC NPI 1073511242

NPI Details

FAIRMOUNT PHARMACY INC is a community/retail pharmacy pharmacy in Philadelphia, PA. 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. FAIRMOUNT PHARMACY INC NPI is 1073511242. The provider is registered as an organization entity type.
The provider Is Doing Business As Fairmount Pharmacy Inc.

The provider's business location address is:

1900 GREEN ST
PHILADELPHIA, PA
ZIP 19130-207
Phone: (215) 567-0364
Fax: (215) 567-1931

The provider's authorized official is Gerard Volgraf .
The authorized official title is Pharmacist Manager And Vp and has the following contact phone number (215) 567-0364.

The CLIA number assigned to this NPI record is 39D0200609 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
• Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home (HCPCS:M0201)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
• Fee covid-19 vac 13 res (HCPCS:0124A)
• Fee covid-19 vac 14 res (HCPCS:0134A)
• Adm sarscv2 30mcg trs-sucr 1 (HCPCS:0051A)
• Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)
• Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)

The enumeration date for this NPI number is 7/12/2005 and was last updated on 2/23/2015.

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:

Other Identifiers

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