Provider Demographics
NPI:1548803760
Name:FITZGERALD PHARMACY INC
Entity Type:Organization
Organization Name:FITZGERALD PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MELVIN
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:804-353-7726
Mailing Address - Street 1:1011 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-1156
Mailing Address - Country:US
Mailing Address - Phone:804-355-1777
Mailing Address - Fax:804-358-0426
Practice Address - Street 1:1011 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-1156
Practice Address - Country:US
Practice Address - Phone:804-355-1777
Practice Address - Fax:804-358-0426
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FITZGERALD PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-21
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy