Provider Demographics
NPI:1093064172
Name:FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:FAMILY PHARMACY LLC
Other - Org Name:FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:R.PH
Authorized Official - Prefix:
Authorized Official - First Name:SACHINKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-543-2852
Mailing Address - Street 1:206 N CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NINETY SIX
Mailing Address - State:SC
Mailing Address - Zip Code:29666-1011
Mailing Address - Country:US
Mailing Address - Phone:864-543-2852
Mailing Address - Fax:864-543-2982
Practice Address - Street 1:206 N CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:NINETY SIX
Practice Address - State:SC
Practice Address - Zip Code:29666-1011
Practice Address - Country:US
Practice Address - Phone:864-543-2852
Practice Address - Fax:864-543-2982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14098333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4230950OtherNCPDP PROVIDER IDENTIFICATION NUMBER