Provider Demographics
NPI:1225223639
Name:FAMILY CARE PHARMACY III INC
Entity Type:Organization
Organization Name:FAMILY CARE PHARMACY III INC
Other - Org Name:FAMILY CARE PHARMACY III INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RX MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:301-839-6000
Mailing Address - Street 1:6196 OXON HILL RD
Mailing Address - Street 2:STE 130
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3100
Mailing Address - Country:US
Mailing Address - Phone:301-839-6000
Mailing Address - Fax:301-839-6002
Practice Address - Street 1:6196 OXON HILL RD
Practice Address - Street 2:STE 130
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3100
Practice Address - Country:US
Practice Address - Phone:301-839-6000
Practice Address - Fax:301-839-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2010-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP046593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133546OtherNCPDP PROVIDER IDENTIFICATION NUMBER