Provider Demographics
NPI:1639459605
Name:FAMILY PHARMACY SOLUTIONS INC
Entity Type:Organization
Organization Name:FAMILY PHARMACY SOLUTIONS INC
Other - Org Name:FAMILY PHARMACY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:917-806-4067
Mailing Address - Street 1:48 CURLEY ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2706
Mailing Address - Country:US
Mailing Address - Phone:917-806-4067
Mailing Address - Fax:718-253-1568
Practice Address - Street 1:890 GARRISON AVE
Practice Address - Street 2:B317
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10474-5332
Practice Address - Country:US
Practice Address - Phone:718-764-1002
Practice Address - Fax:718-294-3385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0308183336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03368449Medicaid
2132247OtherPK