Provider Demographics
NPI:1578519401
Name:FAMILY PHARMACY INC
Entity Type:Organization
Organization Name:FAMILY PHARMACY INC
Other - Org Name:FAMILY PHARMACY OF HAMPSTEAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:YOSPA
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:410-239-3100
Mailing Address - Street 1:907 S MAIN ST
Mailing Address - Street 2:STE A
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-2273
Mailing Address - Country:US
Mailing Address - Phone:410-239-3100
Mailing Address - Fax:410-239-6141
Practice Address - Street 1:907 S MAIN ST
Practice Address - Street 2:STE A
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-2273
Practice Address - Country:US
Practice Address - Phone:410-239-3100
Practice Address - Fax:410-239-6141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336L0003X
MDP045673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD401362900Medicaid
2033160OtherPK
0390810001Medicare NSC