MEDICARE: FAIRVIEW PRODUCE PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy

General Provider Information

NPI Number	:	1215705447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRVIEW PRODUCE PHARMACY LLC

Provider Business Mailing Address
First Line	:	7600 N 16TH ST STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-4446
Country	:	US
Telephone Number	:	833-745-6644
Fax Number	:

Provider Business Practice Location Address
First Line	:	2555 W FAIRVIEW ST STE 104
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85224-4708
Country	:	US
Telephone Number	:	833-745-6644
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BRETT BANNISTER
Credential	:
Telephone Number	:	833-745-6644

Provider Enumeration Date	:	12/18/2023
Last Update Date	:	05/07/2026

Similar Medicare Providers

1154092096 — DR. WILLIAM BERKO ASSIBEY JR. PHARMD
Practice Location Address:

2555 W FAIRVIEW ST STE 104
CHANDLER, AZ
85224-4708

Practice Phone: 480-705-6200
Practice Fax:

1912553553 — SPEECH THERAPY TIME LLC
Practice Location Address:

4708 E COUNTY DOWN DR
CHANDLER, AZ
85249-7342

Practice Phone: 480-710-5835
Practice Fax:

1053467019 — DR. JAMES DOUGLAS LOO M.D.
Practice Location Address:

485 S DOBSON RD , SUITE 111
CHANDLER, AZ
85224-5602

Practice Phone: 480-821-4701
Practice Fax: 480-821-4708

1275688418 — MRS. JACQUELINE LEA FRETTO FNP
Practice Location Address:

485 S DOBSON RD , SUITE 111
CHANDLER, AZ
85224-5602

Practice Phone: 480-821-4701
Practice Fax: 480-821-4708

1932450533 — JAMES LOO, M.D., P.C.
Practice Location Address:

1870 W FRYE RD , SUITE #1
CHANDLER, AZ
85224-6233

Practice Phone: 480-821-4701
Practice Fax: 480-821-4708

1184039968 — KIONGLEE JUNG FNP/PMHNP
Practice Location Address:

2430 W RAY RD STE 3
CHANDLER, AZ
85224-3552

Practice Phone: 480-613-9599
Practice Fax: 480-900-8515

Directions to “FAIRVIEW PRODUCE PHARMACY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.