Provider Demographics
NPI:1497743553
Name:FAMILY CARE PHARMACY INC
Entity Type:Organization
Organization Name:FAMILY CARE PHARMACY INC
Other - Org Name:FAMILY CARE PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:804-740-3300
Mailing Address - Street 1:2576 GAYTON CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-6912
Mailing Address - Country:US
Mailing Address - Phone:804-740-3300
Mailing Address - Fax:804-740-6443
Practice Address - Street 1:2576 GAYTON CENTRE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-6912
Practice Address - Country:US
Practice Address - Phone:804-740-3300
Practice Address - Fax:804-740-6443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
VA02010033683336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8517908Medicaid
2107089OtherPK
DE031890800Medicaid
2107089OtherPK