Provider Demographics
NPI:1588292189
Name:FAMILY PHARMACY INC
Entity type:Organization
Organization Name:FAMILY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-831-6116
Mailing Address - Street 1:610 QUINTARD DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-1840
Mailing Address - Country:US
Mailing Address - Phone:256-831-6116
Mailing Address - Fax:
Practice Address - Street 1:146 VILLAGE LN
Practice Address - Street 2:
Practice Address - City:WEDOWEE
Practice Address - State:AL
Practice Address - Zip Code:36278-4585
Practice Address - Country:US
Practice Address - Phone:256-357-4614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL161511Medicaid
AL168025Medicaid