Provider Demographics
NPI:1487642062
Name:FAMILY CARE PHARMACY INC
Entity Type:Organization
Organization Name:FAMILY CARE PHARMACY INC
Other - Org Name:TRUE CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEEVA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-279-2931
Mailing Address - Street 1:995 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-1526
Mailing Address - Country:US
Mailing Address - Phone:845-279-2931
Mailing Address - Fax:845-279-2098
Practice Address - Street 1:995 ROUTE 22
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-1526
Practice Address - Country:US
Practice Address - Phone:845-279-2931
Practice Address - Fax:845-279-2098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-08
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0255603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3329340OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NY02358083Medicaid