Provider Demographics
NPI:1083952154
Name:FAMILY DRUG INC.
Entity Type:Organization
Organization Name:FAMILY DRUG INC.
Other - Org Name:SWEET SPOT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YIFEI
Authorized Official - Middle Name:
Authorized Official - Last Name:FANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-505-8999
Mailing Address - Street 1:8655 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5820
Mailing Address - Country:US
Mailing Address - Phone:718-505-8999
Mailing Address - Fax:
Practice Address - Street 1:8655 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5820
Practice Address - Country:US
Practice Address - Phone:718-505-8999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0308273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03561479Medicaid
NY03561479Medicaid