FALLON WELLNESS PHARMACY (NPI# 1215077532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215077532 |
| Entity Type | Organization |
| Organization Name | FALLON WELLNESS PHARMACY |
| Practice Address |
1057 Troy Schenectady Rd Latham NY 12110-1002 |
| Practice Telephone | 5182202005 |
| Practice Fax Number | 5182205004 |
| Mailing Telephone | 5182202005 |
| Mailing Fax Number | 5182205004 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. PETER LAWRENCE FALLON (PHARMACIST) |
| Authorized Official Telephone | 5182202005 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
026112 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02443983 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | FALLON WELLNESS PHARMACY, L.L.C. | 1057 Troy-Schenectady Rd, Latham, New York 12110 |
| Street Address |
1057 TROY SCHENECTADY RD |
| City | LATHAM |
| State | NY |
| Zip Code | 12110-1002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588715189 | Amber Lynn Vitse | Nutritionist | 1057 Troy Schenectady Rd, Latham, NY 12110-1002 | 2007-01-12 |
| 1407483860 | Sara L Delvecchio | Pharmacist | 1057 Troy Schenectady Rd, Latham, NY 12110-1002 | 2020-03-25 |
| 1336654995 | Carol Morra | Pharmacist | 1057 Troy Schenectady Rd, Latham, NY 12110-1002 | 2017-12-05 |
| 1780129619 | Peter L Fallon | Pharmacist | 1057 Troy Schenectady Rd, Latham, NY 12110-1002 | 2017-01-02 |
| 1699163204 | Erika Fallon | Pharmacist | 1057 Troy Schenectady Rd, Latham, NY 12110-1002 | 2015-01-05 |
| 1174911754 | Fallon Wellness Pharmacy, LLC | Pharmacy | 1057 Troy Schenectady Rd, Latham, NY 12110-1002 | 2015-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154963973 | Bayley Archinal | Physical Therapist | 711 Troy-schenectady Road, Ste 216, Latham, NY 12110 | 2019-10-14 |
| 1114410701 | Kimberly A. Hostig Licensed Clinical Social Worker Pllc | Clinic/Center | 8 Stanley Cir Ste 11, Latham, NY 12110 | 2018-06-08 |
| 1710477260 | Colleen Phillips | Physical Therapist | 711 Troy Schenectady Rd Ste 216, Latham, NY 12110 | 2018-05-10 |
| 1528574779 | Deborah Cannon | Specialist | 33c Waterford Avenue East, Latham, NY 12110 | 2017-12-26 |
| 1730600149 | Michael Navarrete | Dentist | 231 Wade Road Ext Unit 101, Latham, NY 12110 | 2017-07-06 |
| 1316499452 | Colonie Asc LLC | Clinic/Center | 207 Troy-schenectady Rd, Colonie, NY 12110 | 2016-10-25 |
| 1720539950 | Tania M Durante | Pharmacist | 1057 Troy-schenectady Rd, Latham, NY 12110 | 2016-10-24 |
| 1417344987 | New York Epilepsy Medicine, PC | Clinic/Center | 3 Lear Jet Ln Ste 203, Latham, NY 12110 | 2015-04-22 |
| 1346664752 | Lauren Gannon | Registered Nurse | 95 Forts Ferry Road, Latham, NY 12110 | 2014-02-06 |
| 1649522756 | Natasha Kapsaroff-ruiz | Nurse Practitioner | 654 Watervliet Shaker Rd, Latham, NY 12110 | 2012-10-12 |
| Find all providers in zip 12110 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
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| 1467955385 | Avchemists LLC | Pharmacy | 68-28 Myrtle Ave, Glendale, NY 11385 | 2018-03-16 |
| 1134622079 | Evers Cambria Inc | Pharmacy | 20807b Linden Blvd, Cambria Heights, NY 11411 | 2018-03-16 |
| 1548707516 | Cmv Pharmacy Inc | Pharmacy | 1017 Madison Marketplace, Hamilton, NY 13346-2343 | 2017-01-27 |
| 1922461540 | Katonah Pharmacy Inc | Pharmacy | 202 Katonah Ave, Katonah, NY 10536-2110 | 2016-03-31 |
| 1295198828 | Advanced Pharmacy Inc | Pharmacy | 6929 Myrtle Ave, Glendale, NY 11385-7265 | 2016-03-31 |
| 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.