Provider Demographics
NPI:1003871492
Name:FAMILY PHYSICIANS RX INC
Entity Type:Organization
Organization Name:FAMILY PHYSICIANS RX INC
Other - Org Name:FIVE STAR RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:MAXINE
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-919-7399
Mailing Address - Street 1:400 ANSIN BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-3104
Mailing Address - Country:US
Mailing Address - Phone:305-760-2053
Mailing Address - Fax:954-321-9141
Practice Address - Street 1:901 N MIAMI BEACH BLVD STE 1
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3720
Practice Address - Country:US
Practice Address - Phone:305-874-0072
Practice Address - Fax:305-627-3114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH218843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102279900Medicaid
2006620OtherPK