Provider Demographics
NPI:1578568002
Name:THE FAMILY PHARMACY INC
Entity Type:Organization
Organization Name:THE FAMILY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CLAPPER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:724-346-4521
Mailing Address - Street 1:2199 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2729
Mailing Address - Country:US
Mailing Address - Phone:724-346-4521
Mailing Address - Fax:724-346-4523
Practice Address - Street 1:2199 E STATE ST
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2729
Practice Address - Country:US
Practice Address - Phone:724-346-4521
Practice Address - Fax:724-346-4523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415568L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001928210000124Medicaid
PA4651770001Medicare NSC