Provider Demographics
NPI:1265900153
Name:FALCON PHARMACY INVESTMENTS LLC
Entity type:Organization
Organization Name:FALCON PHARMACY INVESTMENTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:937-347-1200
Mailing Address - Street 1:28 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-2938
Mailing Address - Country:US
Mailing Address - Phone:937-347-1200
Mailing Address - Fax:937-708-8888
Practice Address - Street 1:28 W MAIN ST
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-2938
Practice Address - Country:US
Practice Address - Phone:937-347-1200
Practice Address - Fax:937-708-8888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0242102Medicaid