Fairmont Pharmacy
Fairmont Pharmacy is a healthcare organization registered as Long Term Care Pharmacy in Lodi, CA, holding Type 2 (organization) NPI 1104694371 since 2023. The authorized official on file is Beatle Tran, Ceo.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1104694371 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Fairmont Pharmacy |
| Parent organization | Fairmont Pharmacy |
| Practice address | 1121 W VINE ST #13, Lodi, CA, 95240 |
| Phone | 2096258633 |
| Fax | 2096258629 |
| Enumeration date | 2023-12-18 |
| Last updated in NPPES | 2023-12-18 |
Authorized official
| Name | Beatle Tran |
|---|---|
| Title | Ceo |
| Phone | 9169389556 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336L0003X | Long Term Care Pharmacy | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689063331 | Medicaid | CA | — |
| PHY52074 | Other | CA | FACILITY STATE LICENSE - CALIFORNIA |
Copy-ready billing details
Provider: Fairmont Pharmacy NPI: 1104694371 Taxonomy: 3336L0003X (Long Term Care Pharmacy) Address: 1121 W VINE ST #13, Lodi, CA, 95240
Verify this record
Cross-check NPI 1104694371 against the authoritative CMS record: view Fairmont Pharmacy on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
How current is this record?
Where is Fairmont Pharmacy located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-12-18.