Provider Demographics
NPI:1528471547
Name:FAMILY DISCOUNT PHARMACY INC
Entity type:Organization
Organization Name:FAMILY DISCOUNT PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP/SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-587-4008
Mailing Address - Street 1:4833 CHAUDRON RD
Mailing Address - Street 2:
Mailing Address - City:MOLINO
Mailing Address - State:FL
Mailing Address - Zip Code:32577-6008
Mailing Address - Country:US
Mailing Address - Phone:850-587-4008
Mailing Address - Fax:
Practice Address - Street 1:2117 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-1163
Practice Address - Country:US
Practice Address - Phone:251-867-3001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-06
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1143843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146232OtherPK