Healthcare Provider Details

I. General information

NPI: 1861949265
Provider Name (Legal Business Name): FALCON PHARMACY INVESTMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2016
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12459 EAST US RT 22 3
SABINA OH
45169
US

IV. Provider business mailing address

12459 EAST US RT 22 3
SABINA OH
45169
US

V. Phone/Fax

Practice location:
  • Phone: 937-584-2424
  • Fax: 937-584-5348
Mailing address:
  • Phone: 937-584-2424
  • Fax: 937-584-5348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number022642900-03
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GARY M BARR
Title or Position: OWNER
Credential: PHARMD
Phone: 937-584-2424