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FAIRMONT PHARMACY
NPI 1104694371
Pharmacy - Long Term Care Pharmacy in Lodi, CA

Active since December 18, 2023
1121 W VINE ST #13, LODI, CA 95240(209) 625-8633(209) 625-8629 Get Directions Write a Review

NPPES record last updated: December 18, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Fairmont Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRMONT PHARMACY (NPI 1104694371) is a healthcare organization registered as a long term care pharmacy in Lodi, California and active in the NPI registry since December 2023. The organization lists Beatle Thien-phuoc Tran, Ceo, as its authorized official.

NPPES Registry Identity

NPI1104694371
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameFAIRMONT PHARMACY
Location Address1121 W VINE ST #13Lodi, CA 95240
Mailing Address1121 W Vine St #13Lodi, CA 95240 · (209) 625-8633 · Fax (209) 625-8629
Phone(209) 625-8633
Fax(209) 625-8629
Organization SubpartYes
Authorized OfficialBeatle Thien-phuoc TranCeo · (916) 938-9556
Enumeration DateDecember 18, 2023
NPPES CertifiedDecember 16, 2023
✔ NPI 1104694371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

Other Names 1

Other NameFairmont Pharmacy Ltc

Other Identifiers 2

Medicaid1689063331CA
OtherPHY52074CA · Facility State License - California

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fairmont Pharmacy's NPI number?

The NPI number for Fairmont Pharmacy is 1104694371. It was assigned to this organization in the NPPES registry on December 18, 2023. The provider is also known as Fairmont Pharmacy Ltc.

Where is Fairmont Pharmacy located?

Fairmont Pharmacy is located at 1121 W Vine St #13, Lodi, CA 95240. The listed phone number is (209) 625-8633.

What is Fairmont Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

What insurance does Fairmont Pharmacy accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 33 other insurers list Fairmont Pharmacy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fairmont Pharmacy was last updated on December 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.