Provider Demographics
NPI:1851313829
Name:FAMILY CARE PHARMACY
Entity Type:Organization
Organization Name:FAMILY CARE PHARMACY
Other - Org Name:GLENN'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:334-298-2577
Mailing Address - Street 1:2413 CRAWFORD RD
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-3648
Mailing Address - Country:US
Mailing Address - Phone:334-298-2577
Mailing Address - Fax:334-291-0190
Practice Address - Street 1:2413 CRAWFORD RD
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-3648
Practice Address - Country:US
Practice Address - Phone:334-298-2577
Practice Address - Fax:334-291-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL104605332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0197520001Medicare ID - Type Unspecified