Provider Demographics
NPI:1659489748
Name:FAMILY PHARMACY INC
Entity Type:Organization
Organization Name:FAMILY PHARMACY INC
Other - Org Name:QUICK MEDS EXPRESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-831-6116
Mailing Address - Street 1:610 QUINTARD DR.
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203
Mailing Address - Country:US
Mailing Address - Phone:256-831-6116
Mailing Address - Fax:866-928-5017
Practice Address - Street 1:1542 US HIGHWAY 78 E
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-8063
Practice Address - Country:US
Practice Address - Phone:256-832-6337
Practice Address - Fax:877-917-3056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
AL1121993336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL119217Medicaid
2125248OtherPK