Provider Demographics
NPI:1083146328
Name:UNITED FAMILY PHARMACY, LLC
Entity Type:Organization
Organization Name:UNITED FAMILY PHARMACY, LLC
Other - Org Name:UNITED FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:DI MEMMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-654-0995
Mailing Address - Street 1:1221 S SAN JACINTO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583
Mailing Address - Country:US
Mailing Address - Phone:951-392-6416
Mailing Address - Fax:
Practice Address - Street 1:1221 S. SAN JACINTO AVE
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583
Practice Address - Country:US
Practice Address - Phone:888-258-8386
Practice Address - Fax:954-697-0459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY557353336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy