Provider Demographics
NPI:1902948854
Name:FAY PHARMACY
Entity Type:Organization
Organization Name:FAY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:FAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-742-3440
Mailing Address - Street 1:400 AUDUBON STREET
Mailing Address - Street 2:BOX 608
Mailing Address - City:ADAIR
Mailing Address - State:IA
Mailing Address - Zip Code:50002-0608
Mailing Address - Country:US
Mailing Address - Phone:641-742-3440
Mailing Address - Fax:641-742-3154
Practice Address - Street 1:400 AUDUBON STREET
Practice Address - Street 2:
Practice Address - City:ADAIR
Practice Address - State:IA
Practice Address - Zip Code:50002-0608
Practice Address - Country:US
Practice Address - Phone:641-742-3440
Practice Address - Fax:641-742-3154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA26183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty