PROFESSIONAL PHARMACY FAIRVIEW
NPI 1417306200
Pharmacy - Community/Retail Pharmacy in Santa Ana, CA

Q: What is Fairview Mtm Pharma, Inc's NPI number?

The NPI number for Fairview Mtm Pharma, Inc is 1417306200. It was assigned to this organization in the NPPES registry on June 13, 2016.

Q: What is Fairview Mtm Pharma, Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since June 13, 2016

1002 N FAIRVIEW ST, SANTA ANA, CA 92703(714) 881-0012(714) 486-2378 Get Directions Write a Review

NPPES record last updated: February 20, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 20, 2023, Feb 9, 2022, Jul 2, 2021 and 3 more (6 updates tracked since 2016).

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About Professional Pharmacy Fairview NPPES

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

PROFESSIONAL PHARMACY FAIRVIEW (NPI 1417306200) is a healthcare organization registered as a community/retail pharmacy in Santa Ana, California and active in the NPI registry since June 2016. The organization lists Denise T. Le, President/ceo/pic, as its authorized official.

NPPES Registry Identity

NPI1417306200

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameFAIRVIEW MTM PHARMA, INC

Location Address1002 N FAIRVIEW STSanta Ana, CA 92703-1811

Mailing Address1002 N Fairview StSanta Ana, CA 92703-1811 · (714) 881-0012 · Fax (714) 881-4321

Phone(714) 881-0012

Fax(714) 486-2378

Organization SubpartNo

Authorized OfficialDenise T. LePresident/ceo/pic · (714) 881-0012

Enumeration DateJune 13, 2016

Last NPPES UpdateFebruary 20, 20236 updates tracked since enumeration

NPPES CertifiedFebruary 20, 2023

✔ NPI 1417306200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in CA · PHY54449

Definition

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.

Also ListedPharmacy · Specialty PharmacyTaxonomy 3336S0011X

1002 N FAIRVIEW ST, Santa Ana, CA 92703

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Other Names 1

Doing Business AsProfessional Pharmacy Fairview

Other Identifiers 2

Medicaid1417306200CA

OtherPHY 54449CA · California State Board Of Pharmacy Permit

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 ›

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

50 services50 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

48 services48 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

22 services22 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

15 services15 patients

Medical Equipment Supplier Medicare DMEPOS 13

Medicare supplier enrollment and the product categories Professional Pharmacy Fairview carries, from the Medicare DMEPOS supplier directory.

Professional Pharmacy Fairview

DMEPOS supplier · Santa Ana, CAOperated by Fairview Mtm Pharma Inc

✔

Accepts Medicare assignment

Professional Pharmacy Fairview agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20454413

Medicare Participant SinceJuly 1, 2018

Supplier Location1002 N Fairview StSanta Ana, CA 92703

Phone(714) 881-0012

Supplier Specialties

Pharmacy

Medicare Product Categories

Epoetin

Epoetin is a man-made version of human erythropoietin (EPO)

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Infusion Drugs

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Blood Glucose Monitors/Supplies (Non-Mail Order)

Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVA FELICE POTTS NP

Nurse Practitioner