FAIRMOUNT PHARMACY (NPI# 1104931138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104931138 |
| Entity Type | Organization |
| Organization Name | FAIRMOUNT PHARMACY |
| Practice Address |
124 N Main St Fairmount IN 46928-1654 |
| Mailing Address |
610 E Romie Ln Salinas CA 93901-4209 |
| Practice Telephone | 7659484111 |
| Practice Fax Number | 7659484226 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BRADLEY CRUMP (PRESIDENT) |
| Authorized Official Telephone | 8317580976 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| X | 333600000X | Pharmacy | 60005862A | IN | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1505760 | 01 |
| Street Address |
124 N MAIN ST |
| City | FAIRMOUNT |
| State | IN |
| Zip Code | 46928-1654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265523955 | Bradley Alan Crump | Pharmacist | 124 N Main St, Fairmount, IN 46928-1654 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245325695 | Erin Kriehn | Pharmacist | 1385 N. Baldwin Ave., Marion, IN 46928 | 2006-10-03 |
| 1750391975 | Anthony S Hill | Internal Medicine | 157 W Eighth St, Fairmount, IN 46928-1012 | 2006-08-09 |
| 1043291644 | Bharatkumar D Patel | Internal Medicine | 157 W 8th St, Fairmount, IN 46928-1012 | 2005-11-10 |
| 1447577275 | Marcie Lousie Baird | Nurse Practitioner | 157 W Eighth St, Fairmount, IN 46928-1012 | 2010-05-04 |
| 1619020575 | Marion General Hospital | Internal Medicine | 157 W 8th St, Fairmount, IN 46928-1012 | 2007-01-22 |
| 1154474542 | Marion General Hospital | Internal Medicine | 157 W 8th St, Fairmount, IN 46928-1012 | 2007-01-19 |
| 1679554901 | Kundanbala Patel | Internal Medicine | 157 W 8th St, Fairmount, IN 46928-1012 | 2005-11-14 |
| 1518412139 | Fairmount Family Dentist | Clinic/Center | 215 E Washington St, Fairmount, IN 46928-1747 | 2016-08-24 |
| 1730240722 | Bruce E Dryer | Dentist | 215 E Washington St, Fairmount, IN 46928-1747 | 2006-12-13 |
| 1770844276 | Angela Joyce Grandlienard | Counselor | 108 S Main St, Fairmount, IN 46928-1923 | 2012-06-01 |
| Find all providers in zip 46928 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598364176 | Jace Medical LLC | Durable Medical Equipment & Medical Supplies | 3516 Commerce Dr, Warsaw, IN 46580-3925 | 2020-10-23 |
| 1760081525 | After Action Medical and Dental Supply, LLC | Durable Medical Equipment & Medical Supplies | 4444 Decatur Blvd., Suite 100, Indianapolis, IN 46241 | 2020-10-22 |
| 1588263628 | Riyff LLC | Durable Medical Equipment & Medical Supplies | 162 W Carmel Dr, Carmel, IN 46032-2526 | 2020-10-20 |
| 1487261897 | J & Y Medical LLC | Durable Medical Equipment & Medical Supplies | 227 E Dupont Rd, Fort Wayne, IN 46825-2047 | 2020-09-29 |
| 1245844000 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1441 E 84th Pl Rm 120, Merrillville, IN 46410-6578 | 2020-08-31 |
| 1598376485 | The South Bend Clinic LLP | Durable Medical Equipment & Medical Supplies | 6301 University Commons Ste 100, South Bend, IN 46635-1571 | 2020-08-13 |
| 1427676634 | Undranita Gilbert | Durable Medical Equipment & Medical Supplies | 12077 Stern Dr, Indianapolis, IN 46256-9442 | 2020-07-14 |
| 1487272142 | Perennial Health LLC | Durable Medical Equipment & Medical Supplies | 15736 Viking Commander Way, Westfield, IN 46074-7742 | 2020-07-09 |
| 1710503693 | Diabetic Equipment and Supplies LLC | Durable Medical Equipment & Medical Supplies | 3905 Vincennes Rd Ste 405, Indianapolis, IN 46268-3026 | 2020-06-17 |
| 1275158198 | Jennmike Inc. | Durable Medical Equipment & Medical Supplies | 525 N Green River Rd, Evansville, IN 47715-2472 | 2020-06-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.