Provider Demographics
NPI:1396152054
Name:FAMILI-CARE PHARMACY, INC
Entity type:Organization
Organization Name:FAMILI-CARE PHARMACY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ONWUANAIBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-272-6424
Mailing Address - Street 1:11100 LIBERTY RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-1026
Mailing Address - Country:US
Mailing Address - Phone:443-272-6424
Mailing Address - Fax:443-272-6425
Practice Address - Street 1:11100 LIBERTY RD STE D
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-1054
Practice Address - Country:US
Practice Address - Phone:443-272-6424
Practice Address - Fax:443-272-6425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-15
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 333600000X
MDP063313336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147560OtherPK