Provider Demographics
NPI:1063648384
Name:HOWARD FAMILY PHARMACY INC
Entity Type:Organization
Organization Name:HOWARD FAMILY PHARMACY INC
Other - Org Name:HOWARD FAMILY PHARMACY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-422-0688
Mailing Address - Street 1:1453 PRATER FRK
Mailing Address - Street 2:
Mailing Address - City:HUEYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41640-8880
Mailing Address - Country:US
Mailing Address - Phone:606-422-0688
Mailing Address - Fax:
Practice Address - Street 1:327 KY ROUTE 550
Practice Address - Street 2:
Practice Address - City:EASTERN
Practice Address - State:KY
Practice Address - Zip Code:41622-6925
Practice Address - Country:US
Practice Address - Phone:606-358-4800
Practice Address - Fax:606-358-9706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
KYP073433336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100070500Medicaid
2119938OtherPK
KY7100108850Medicaid
KY7100108850Medicaid