Provider Demographics
NPI:1790175008
Name:FATHER & SON PHARMACEUTICALS, LLC
Entity Type:Organization
Organization Name:FATHER & SON PHARMACEUTICALS, LLC
Other - Org Name:ANTHONY'S FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:FOSSACECA
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:330-469-6421
Mailing Address - Street 1:8600 E MARKET ST
Mailing Address - Street 2:SUITE #9
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2375
Mailing Address - Country:US
Mailing Address - Phone:330-469-6421
Mailing Address - Fax:
Practice Address - Street 1:8600 E MARKET ST
Practice Address - Street 2:SUITE #9
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2375
Practice Address - Country:US
Practice Address - Phone:330-469-6421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy