Provider Demographics
NPI:1306174131
Name:FAMILY PHARMACY, LLC.
Entity type:Organization
Organization Name:FAMILY PHARMACY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KHOLOUD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:609-426-0441
Mailing Address - Street 1:2025 OLD TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-2412
Mailing Address - Country:US
Mailing Address - Phone:609-426-0441
Mailing Address - Fax:609-426-0443
Practice Address - Street 1:2025 OLD TRENTON RD
Practice Address - Street 2:
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-2412
Practice Address - Country:US
Practice Address - Phone:609-426-0441
Practice Address - Fax:609-426-0443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RF006995003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0222160Medicaid