Provider Demographics
NPI:1699059436
Name:FAMILY PHARMACY SOLUTIONS INC
Entity type:Organization
Organization Name:FAMILY PHARMACY SOLUTIONS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-806-4067
Mailing Address - Street 1:2066 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4314
Mailing Address - Country:US
Mailing Address - Phone:718-377-4900
Mailing Address - Fax:718-253-1568
Practice Address - Street 1:781 E 142ND ST
Practice Address - Street 2:1ST FL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-1723
Practice Address - Country:US
Practice Address - Phone:718-764-1002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0308183336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5803590OtherNCPDP PROVIDER IDENTIFICATION NUMBER